Cypress Assisted Living Blog


POSTED: December 27, 2012

I read this the other day in “Heart Insight” and thought it was worth passing on.

 

Peter Ross remembers the day when his organization received a call from a distressed woman who needed assistance placing her mother in a nursing home.

 

“Her mother had no medical problems,” recalls Ross, CEO of Senior Helpers, a national in-home senior care agency based in Timonium, MD. “The daughter didn’t want mom to (live) alone and thought a nursing home was her only option. The mother was beside herself. Instead, we provided a caregiver five days a week to help supplement her mom’s care.”

 

This scenario happens every day across the country. Many seniors can no longer care for themselves in their own home, or maybe their children can’t manage their growing medical needs. Usually, they believe placing Mom or Grandpa in a nursing home is the only solution. However, families can now turn to other facilities and a wide variety of online or community resources that can help them plan ahead, find the most appropriate long-term care facility for their loved one and identify ways to pay for the care without going bankrupt.

 

What’s Available?

 

Many families are simply unaware of their choices, adds Ross, and think that nursing homes are their only option. Most communities offer a variety of choices, such as:

 

HOME CARE. This full- or part-time service provides individuals with a home care worker who helps them perform daily living activities like bathing or dressing. Ross says the national average hourly rate is $19 per hour.

 

While 90 percent of people over the age of 65 prefer to live at home, according to a 2012 AARP survey, that’s not always possible. Can Mom climb the stairs to her bedroom? What about Dad’s health? Home care workers are not medically trained, so if Dad has health issues, other options like assisted living may be a better fit.

 

INDEPENDENT LIVING. Sometimes referred to as retirement communities, independent living facilities target people age 55 and older and offer housing ranging from senior apartments to free-standing houses that are friendlier to older adults (such as no second floors or stairs) and often more compact. Residents can drive their own cars and participate in group activities and meals. No medical support is provided.

 

GROUP HOMES or BOARD & CARE FACILITIES.  A small number of people live in these licensed homes–mostly in residential neighborhoods—when they cannot live on their own but don’t need nursing home services.  Line-in staff provides daily care, meals and activities.  Most facilities are wheelchair accessible.

 

ASSISTED LIVING.  These facilities are for seniors who have experienced a slight decline in their health and need assistance performing daily activities.  Residents are served three meals each day, can participate in various activities and trips and can often bring a pet if they can care for the animal.

NURSING HOMES.  Sometimes called skilled nursing facilities, this option offers the highest level of both custodial care, such as bathing and dressing, and medical care for older adults outside of a hospital.  Some also have special living areas designed for Alzheimer’s or dementia patients.  Doctors supervise each patient’s care.  Round-the-clock medical care is usually provided.

 

Some of these facilities may be covered under some private long-term care insurance or other assistance programs.  Check with your insurance company and Medicaid or Medicare to see what your policy covers.

 

To determine what type of facility your family member may need, call his or her physician, says Ross.  Then contact an elder care attorney, social worker or placement service for financial and other types of assistance.

 

“There are a lot of people out there who can help you,” Ross says.  “Narrow down your search once you understand where (your loved one) should be going.  Get information on how well-rated (each) facility is and make sure (you or ) someone you trust tours the facility.”  To find ratings on facilities in the United States, visit medicare.gov/NursingHomeCompare.

 

LETTING GO

 

The emotional impact ov moving family members from their home to another facility can be devastating for everyone involved, but there are ways to make it a bit easier.

 

“Nobody ever wants to move out of (his or her) house,” says Marion Somers, Ph.D., and elder care specialist in Gardenia, Calif. “But you have to face it realistically.  If you keep shoving the issue under the rug, all you’ll get is a lumpy rug that you’re going to trip over somewhere along the line.

 

She says family caregivers need to educate themselves about the disease their loved one has, so they can talk openly with them about it and be better prepared to manage the illness as it advances.

 

Somers suggests creating a list of key questions.  “Deal with things one sentence at a time because (your loved one) is dealing with a lot of emotional issues.” She says.  “Ask the question or state the facts, then wait for him or her to process the information and answer.  You may be on your third question and your loved one is still processing the first question.”

 

Above all, listen.  How is Grandma feeling about moving?  What is your father thinking?  “People need to be heard, understood and have their (lives) validated,? Says Somers.

 

Another strategy involves taking small steps, explains Barbara Ensor, Ph.D., a geriatric psychologist in Baltimore.  A good example is making a decision about the type of facility your loved one needs.  Bring up the idea, then wait a few days and approach the subject again, but this time, go one step further by narrowing your choices.  Use concrete examples like, “Mom, I’m concerned that the next time you fall, you could break your hip.  I want you to be safe.”

 

Often seniors are in complete denial about their health status or ability to care for themselves.  If this happens, respect their opinions and wait a bit before address the topic again.  Also ask yourself if they’re being reasonable or competent.  If so, accept their decision then present options like an in-home caregiver to help ensure their safety.

 

Ensor says a good way to overcome barriers is to use “I” statements, such as, “I can’t pick you up if you fall” or “I worry about you since you live alone.”  If they’re still resistant but need help caring for themselves, ask their physician to intervene.

 

When moving day arrives, involve them in decision-making.  Ask which drawer Grandma wants her sweaters in or which mementos your father wants to take with him.  Present options every step of the way so they still feel some control over their lives.

 

“The biggest thing I hea from seniors is that my children did this ‘for me’ or ‘to me’ and that they didn’t have a chance to say where they wanted the furniture or pictures to go,” says Ensor, adding that grandchildren should also be involved in the moving process.  Take them with you when touring facilities, encourage them to talk with Grandma about moving and make sure they visit her as often as possible to help smooth the transition.

 

Moving people out of their homes is a process that requires both time and patience.  “Try very hard to understand what it’s like for (them),” Ensor says.  “They’re giving up many years of independence, all they built up…It’s a very emotional decision.”

 

CAN YOU AFFORD IT?

 

Make no mistake—long-term care is expensive.  Nursing homes can cost at least $5,000 a month while the price of assisted living facilities can range between $45,000 and $80,000 a year, depending upon their location and amenities, says Harold L. Lustig, a financial advisor at Estate & Elder Planning Associates in San Rafael, Calif.

 

One underutilized source of income is the Veterans Health Administration.  He says veterans over the age of 65 may qualify for a tax-free benefit called Aid & Attendance Special Pension, which can help pay for care in the person’s home, a nursing home or assisted living facility.

 

This benefit is not dependent upon military-related injuries, says Lustig, author of Naked in the Nursing Home: The Women’s Guide to Paying for Long-term Care without Going Broke (2011, Blooming Twig)

 

To financially qualify, veterans must have less than $80,000 in assets, excluding their home and vehicles.  A veteran can receive up to $1,704 a month, while a surviving spouse may be given up to $1,094 each month.  Likewise, a veteran with a spouse is eligible for up to $2,020 per month and a veteran with a sick spouse can receive up to $1,338 each month.  For more information, visit veteranaid.org.

 

Other financial options include reverse mortgages, long-term care insurance or a tax qualified plan, which offers a tax-free benefit that’s calculated on a monthly basis.

 

Generally, the best time to buy an insurance policy is when your loved one is healthy “But in many states, there is life insurance where (to qualify), you answer four to five questions like, ‘Have you been recently hospitalized’, or ‘Have you ever had AIDS?” Lustig says.

 

He tells the story of a 72-year ols woman who was denied long-term care insurance because she had an assortment of medical problems.  But she was able to purchase a $100,000 life insurance policy with a $150,000 death benefit.  He says 90 percent of that $150,000 could be used for her long-term care.

 

Still, Lustig is always amazed at people’s reluctance to purchase any insurance.  Just compare a policy’s annual premium of $6,000 a year to a nursing home that costs $6,000 a month.

 

“When you say it’s too expensive, ask yourself, ‘Compared to what? Spending down all of your assets?” says Lustig.  “When you can’t afford it, get your kids to help pay because they’re going to end up paying anyway.”

 

POSTED: September 23, 2012

I saw this article from the Wall Street Journal and thought it would be appropriate.  We know of several elderly who have been cheated financially.

Older adults are frequent victims of financial fraud, but there often are telltale signs that can help family members recognize something is amiss.

These warnings can be as clear as a sudden inability to pay one’s bills. But often the signals are more subtle: unopened statements from brokerage accounts you didn’t know existed, mail boxes stuffed with sweepstakes offers or the sudden reliance on a “new best friend” for financial advice.

If you think there’s a problem, it’s crucial to persevere. Don’t be surprised if the person at risk doesn’t cooperate as you try to get to the bottom of a potential fraud.

It’s embarrassing to be swindled at any age. Older adults already feeling ill at ease with their abilities, or feeling like their independence is threatened, may have a tough time admitting something has gone wrong and opening up about their finances.

Compounding the challenge is that often the perpetrator is someone the older victim knows and with whom he or she has built a trusting relationship—a member of the victim’s church or veterans group, an accountant or even a family member.

“Seniors are going to be affected by every kind of fraud, because they tend to be the ones that have the savings and the cash,” says Matt Kitzi, Missouri’s securities commissioner.

Prevention starts with being vigilant, says Patty Struck, who heads up Wisconsin’s securities division, which frequently is called upon to investigate fraud among older adults.

Just after Easter several years ago, Ms. Struck’s office received a call from a man who was concerned about his father’s financial adviser. While visiting his father over the holiday, the son learned that the adviser was helping the father take out a new loan on the house—the mortgage having previously been paid off. The adviser had even driven the father to the bank to help him fill out the paperwork, Ms. Struck says.

Seeing no financial need for the loan, the son called Wisconsin regulators. It turned out the adviser was looting clients’ accounts. That included not just the caller’s father, but also his grandmother’s money, as well.

“It’s all about reading between the lines and asking a lot of questions,” says Ms. Struck.

To help ease the process, she suggests that younger family members talk about their own finances with older relatives to help them feel more comfortable opening up. Listen for offhand remarks, such as a comment that their broker isn’t returning phone calls.

Don’t feel guilty about doing some detective work. If there is an open bank statement, check to see if there’s an unexpected name on the account. Other red flags: unusual transfers or big checks being cashed.

If you get the older adult’s cooperation, order a free copy of the person’s credit report. If anyone is opening up new accounts under the person’s name or running up any big credit-card bills it will turn up in the credit report. The older adult may not even have realized he or she is being victimized.

Catherine Ann Seal, an elder-law attorney in Colorado Springs, Colo., says when she gets referrals from the local adult protective-services department for seniors who may have been victimized, one of the first steps she takes is to check public tax and real-estate filings—usually available for free online. She checks if new estate-planning documents or liens or deeds for a home have been filed.

If suspicion revolves around a financial adviser, go to BrokerCheck at the website of the Financial Industry Regulatory Authority (finra.org) to see if a broker has a track record of breaking the rules. Some states let you check online, for a small fee, whether an individual has a criminal record.

A common way older adults fall victim to fraud is what experts call the “new best friend” scam. “The senior all of a sudden has a very strong bond with somebody they have not known for a very long time,” says Ms. Seal.

While those relationships can be on the up and up, con artists will often befriend lonely individuals, sometimes helping with errands or chores to gain their trust. “Very often the elderly people know that what they’re getting into is probably too risky,” Ms. Struck says. “But the person calling them to scam them is so friendly and they’re lonely, so they’re willing to take the time to talk to them.”

More wrenching is when a relative is the one taking advantage of an older person. “Some of the worst exploitation happens among family members,” says Ms. Seal.

Most often, she says, the theft is committed by a family member who is financially dependent on the senior. For example, a parent may be forced to sell a home and use the money to pay for a nursing home. A child, who was counting on the home for an inheritance, then dips into the parent’s savings.

“Transparency is the key,” Ms. Seal says. “Undue influence and exploitation only happens if no one else is aware of what’s going on.”

POSTED: September 19, 2012

I saw this while view the Assisted Living Federation of America site.  It brings to mind the need to watch our loved one’s finances.  We not only need to protect them from outside thiefs but also from unscrupulous family members.

“A new poll examining financial exploitation of American seniors finds that 79 percent of experts surveyed identified theft or diversion of funds by family members as the most common form of financial abuse.

The poll asked state securities regulators, financial planners, health care professionals, social workers, adult protective services workers, law enforcement officials, elder law attorneys, and academics about their experiences with elder abuse. 77 percent of individuals surveyed thought that seniors are very vulnerable to financial abuse, and most cited financial abuse by family members as the most common form of financial abuse. Most respondents indicated that older veterans face the same deception risks as other seniors, but affinity fraud and VA Aid and Attendance fraud were also cited as important problems to address.

About 70 percent of those surveyed reported financial counseling and education programs administered by local professionals, such as caregivers, adult protective services workers, and law enforcement agencies as the most useful tool for helping seniors effectively manage their finances. Programs delivered through senior centers and other senior care organizations and programs delivered by senior oriented national and local organizations were also considered positively by respondents.

Learn more about the financial exploitation surveyLink Icon conducted by the Investor Protection Trust (IPT) and Investor Protection Institute (IPI) in response to questions posed by the Consumer Financial Protection Bureau (CFPB).”

POSTED: August 31, 2012

August 6, 2012 — AUSTIN — Texas State Senator Jane Nelson-R, Flower Mound, has received distinctions from two organizations dedicated to supporting assisted living providers and residents in Texas.

The Assisted Living Federation of America (ALFA) gave Senator Nelson its Statesman Award, and the Texas Assisted Living Association (TALA) named her “2011 Senator of the Year.” These recognitions honor Senator Nelson’s efforts to promote the care of aging Texans, reduce injuries to the elderly, and improve long-term care services.

“These organizations have been tireless advocates on behalf of long-term care providers and clients,” said Senator Nelson. “We have a responsibility to Texas’ aging population, and it is a true honor to be recognized for our efforts to support them.”

Senator Nelson has sponsored legislation creating a volunteer program to assist families in the care of their elderly. She supported a measure to increase awareness of fall prevention and to reduce the cost of fall-related injuries. Under her leadership, the Legislature has passed measures to improve long-term care services and to increase consumer access to related information.

“Each year the Assisted Living Federation of America honors a state legislator who has made an exceptional commitment to advocate on behalf of senior living residents. Senator Jane Nelson has been a true champion for seniors in Texas, and we are proud to present her with the 2012 ALFA Statesman Award,” said Rick Grimes, President and CEO of ALFA. “Throughout her career, she has stood for improvements in care to the elderly,” said Gail Harmon, Executive Director for TALA.

The Assisted Living Federation of America and its Texas affiliate, the Texas Assisted Living Association, advocate on behalf of assisted living facilities and residents to promote informed choice and quality health care.

SENATOR JANE NELSON represents District 12, including portions of Tarrant and Denton Counties. She is Chairman of the Senate Committee on Health & Human Services.

POSTED: July 25, 2012

I saw this in the USA today and thought it was interesting.  We need to do all we can to keep whatever brain cells we have.  Enjoy.
By Janice Lloyd, USA TODAY
Moderate drinking and binge drinking among older people increase the risk for cognitive decline and memory loss, according to two studies presented today at the Alzheimer’s Association International Conference 2012 in Vancouver, Canada.
Adults ages 65 and older who reported binge drinking at least twice a month were 2½ times more likely to suffer cognitive and memory declines than similar-aged adults who don’t binge-drink. In this study, binge drinking is defined as four or more drinks on one occasion.
“It’s not just how much you drink but the pattern of your drinking,” says lead author Iain Lang of the University of Exeter in England. “Older people need to be aware, if they do binge-drink, of the risks and they should change their behaviors.”
Binge drinking appears to be a big problem in the USA. The findings follow a study in January by the Centers for Disease Control and Prevention reporting that one in six adults in the USA are binge drinkers and those in the 65-plus age group binge-drink more often than any other age group. In that survey, binge drinking is defined as men having five or more drinks within a short period of time and women having four or more drinks.
Those most likely to binge-drink have incomes of more than $75,000 a year, according to the CDC.
The CDC recommends moderation, if you do drink. It describes moderate drinking as no more than one drink a day for women and no more than two drinks for day for men.
Lang’s eight-year study on binge drinking followed 5,075 U.S. adults ages 65 and older and assessed cognitive function and memory in a telephone survey. Among the findings: 4.3% of men and 0.5% of women reported drinking heavily twice a month or more; another 8.3 % of men and 1.5% of women reported doing so once a month or more.
Earlier studies have noted drinking alcohol in moderation, especially red wine, might decrease the risk of cardiovascular disease, dementia and premature death.
“The many dangers of misuse of alcohol, and some of the possible benefits, have been widely reported, and there needs to be clarification by the scientific community,” says Bill Thies, chief scientific and medical officer for the Alzheimer’s Association. “Certainly no one should start drinking in order to reduce Alzheimer’s risk.”
In another study reported at the conference, researchers found moderate alcohol consumption had no protective properties in the mental functions of older women. The study followed 1,306 women ages 65 and older for 20 years. Among the highlights:
•Women who changed from not drinking to drinking over the course of the study had a 200% increased risk of cognitive impairment compared with non-drinkers.
•Women who reported drinking more in the past than at the beginning of the study were at a 30% increased risk of developing cognitive impairment compared with non-drinkers.
•Moderate drinkers in the late phrase of the study were roughly 60% more likely to develop cognitive impairment compared with nondrinkers.
“Alcohol use in late life many not be beneficial in older women,” says lead author Tina Hoang of The Veterans Health Research Institute in San Francisco. “It may be that the brains of older individuals are more vulnerable to the effects of alcohol.”

POSTED: July 19, 2012

This is the final part of an interesting article from the Wall Street Journal.  Bottom line is that we all need to save and plan on getting no inheritance and then if we do, that’s a bonus.  We also need to think of what will happen if our parents outlive their money and we need to pitch in.  Some definite interesting ideas to consider.  Read on and learn something.
By Anne Tergesen in the Wall Street Journal

Part 3
Measures to Take
If parents anticipate running short of money—and if they and adult children are able to start a dialogue—there are several steps families should consider, financial planners say.  Among them: Have parents recalibrate their budgets, downsize to a smaller residence, buy an annuity or longevity insurance to lock in a life-long income, or take out a reverse mortgage.
In situations where children have adequate financial resources, some advisers recommend the children pay a parent’s health-insurance premiums, purchase a long-term-care insurance policy for him or her, give a set amount of money each month or purchase the parent’s home to generate cash for living expenses.  (Before implementing a strategy, talk with your financial and tax advisers.)
The process can lead to conflict, although the tension typically remains beneath the surface, says Claudia Fine, and executive vice president at SeniorBridge, a New York-based company that provides care-management services.
Very often, she adds, she sees conflict arise over expenditures on caregiving.  “Because feelings about inheritance are not expressed, families have a hard time sorting out their differences.”
Siblings Sort It Out
Linda Fodrini-Johnson, 67, suspects inheritance calculations play a role in differences she and her three brothers have over managing the finances of their mother, Bernice Bidwell, 90.
Ms. Fodrini-Johnson says she and one brother, 60-year-old Craig Bidwell, “don’t need to inherit” from their mother, who recently had a stroke and suffers from congestive heart failure.  But disabilities have prevented the other brothers from working in recent years.
“There is tension,” says Ms. Fodrini-Johnson, who lives in Walnut Creek, Calif., and runs a company that provides care-management services.  “You hear it and feel it, but nobody articulates it because it would be disrespectful to Mom.”
She points to a recent disagreement over her mother’s hair.  She wanted to take her mother to a hairdresser instead of using the one at her mother’s assisted-living facility.  But other siblings resisted.
No one came out and said it was about the cost, Ms. Fodrini-Johnson says, but that seemed to her to be the motivation.  The siblings also debated whether to remodel and rent their mother’s San Francisco home—so it could bring in some money—or allow a grandchild to serve as temporary caretaker of the place.
To avoid conflict, Ms. Fodrini-Johnson says, she solicits her brothers’ opinions and explains the reasons for her decisions as well as the details of her mother’s finances.  But as her mother’s power of attorney, she has the final say.
Her three brothers declined to comment on the hairstylist incident, or said they didn’t know about it.  Tow brother, Craig and 63-year-old Gary Bidwell of San Francisco, say they discussed renting their mother’s house to bring in extra income to offset her expenses.
No Expectations
When it comes to the idea of inheritance, the three brothers are of similar minds.
Robin Bidwell, a 59-year-old in Colfax, Calif., says he sustained an injury at age 48 that has prevented him from working.  While he receives a pension and Social Security, “I wasn’t able to put money away.  I don’t live the life I want to live, but I don’t look to my mother’s inheritance to be on top of things,” he says.  “I believe my mother’s care is first and foremost.  That, to me, is more important than anything.”
“An inheritance would help, but I am not looking forward to it,” says his brother Gary, a 63-year-old who retired on a disability pension in 1998.  “I don’t want an inheritance if I have to lose someone I love.”
Like many adult children, the third brother, Craig, says he hopes to receive an inheritance—in his case to help pay for a new home he and his wife plan to build.  However, the retiree says he is grateful that his mother is able to afford the high-quality care she receives.
“Whatever my mother has is her,” he says.  “It’s not my inheritance.  I didn’t work for it.  My brothers didn’t work for it.  My parents worked for it.?

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