Caregiving is one of the most difficult, time consuming, and ultimately, most rewarding jobs any of us will have. While there are moments of love and joy, there are often many more moments of isolation, feeling overwhelmed, and frustration. It can be difficult to take a step back and look at your own situation, so I like this list of “9 Secrets of Caregiving” by aarp.com. This is good advice from people who are caregivers themselves, on what has helped them be not only effective caregivers, but functional people in many different roles. Highlights:
#4: Accept Today. The caregiver giving this advice is right: it isn’t fair, nor is it realistic, to expect or wish the person you are caring for could be the way they used to be. We all change as we age, and that time has passed. It is fine to remember those days fondly, but it is also important to redefine what is a “good day”: it may be a day with no pain, or a day with improved communication abilities. Living for today will help you bring peace and joy to your current situation, rather than longing for something that can no longer be.
#7: Get the Legal Stuff Done. Of course, your Elder Law Attorney is going to want to help you take care of this business! Making adequate preparations for incapacity can save you time, money, and frustration. Have those difficult conversations – or let us help you do so! – and get it out of the way so you can concentrate on caring for your loved one.
9 Secrets of Caregiving – aarp.com
I ran across a good set of articles in the most recent addition of the CostCo magazine, of all places, that I wanted to share. It includes a short piece of finances, estate planning, downsizing and a Social Security primer. While each of these articles is short, and just barely skims the surface, it is a good reminder that planning to age wisely involves multiple areas of your life, not just one. You can’t ignore your estate plan and concentrate solely on your finances; even the best estate plan may mean that you have to downsize your home eventually; and no financial analysis is complete without considering the benefit you or your family might receive from Social Security. Each of these puzzle pieces must fit together nicely to complete a picture.
I also like the inset box of “Learning Elder Care Language.” It is important to realize all of the different options your family has when taking care of an older adult. I think this box could have one more column, though: How to Pay. Considering the available funding sources for each of these categories is important as well.
Katten & Benson can help you with many of these areas. Our attorneys, Steve, Monica, Sandra (and soon to be Dana!) can help you put together a seamless estate plan that accomplishes your goals in the most simple way. Our social worker, Kim, can help you discover what kind of care is most appropriate for your situation, but can help you identify the right care provider for you. We can also help you access funding sources for different kinds of care, be it through Medicaid, VA Benefits, private insurance, or private pay, or a combination of the above.
Check out this article. Which puzzle piece can Katten & Benson help you with?
Aging Well: Assembling the Essential Pieces for a Secure Future – Costco Connection, September 2011
I wanted to report on a few things that I heard at last night’s town hall meeting. This meeting provided an opportunity for people affected by Alzheimer’s disease to make statements that will influence the National Alzheimer’s Project Act, or NAPA. This act was signed into law last January, and creates a coordinated national plan to address Alzheimer’s research, clinical care, institutional-, home- and community-based programs and outcomes.
Here are a few of the things that struck me:
- There were lots of people in their 40s and 50s who have been diagnosed with early Alzheimer’s, as well as their family members.
- This group with an early diagnosis spoke very movingly about their struggle just to get diagnosed.
- This group also expressed a lot of dissatisfaction with doctors in general for the lack of information and support provided.
- There were many caregivers present, and they all talked about the burden of being caregivers.
- I had heard this statistic before, but it still knocks me over–40% of caregivers will die before the carereceiver, a direct result of the burden of caregiving
These are just a few of the HUGE policy issues related to Alzheimer’s disease that will have to be addressed. A full 50% of people age 85 and older will have dementia, and this age group is the fastest growing age group in the United States right now.
If you want to share your experience with this disease, or offer ideas that could affect policy, you can share input through the Alzheimer’s Association
If you’re like me, most of the time you think there’s little you can do to help change things. But if you know someone with Alzheimer’s, now is your chance to have a voice in shaping future policy.
The Alzheimer’s Association is sponsoring a Town Hall Meeting on August 31. This is your chance to share how this disease impacts you and your family, and share your ideas about how the federal government can help those dealing with the disease. Representative Kay Granger will be there, along with a representative of the Alzheimer’s Association from Washington, DC, and there might also be someone there from the Department of Health and Human Services. I plan to go, and I hope you will, too.
Alzheimer’s Association Town Hall Meeting
Wednesday, August 31, 2011
5:30 pm to 7:000 pm
UNT Health Science Center
Medical Education & Training Building
1000 Montgomery Street
Fort Worth, TX 76107
For more information and directions visit
Seating is limited, so please RSVP by August 26
817-336-4949 or 1-800-272-3900
One of the best blogs I have found about aging is the New Old Age blog in the New York Times, which recently had a post about hospitalists. Back in the day, if you went to the hospital, you let your primary care physician (PCP) know, and he or she would come see you, and oversee your care while you were in the hospital. Since the 1990s, hospitalists have taken over the care of most people in the hospital. Hospitalists are often employed directly by the hospital, or they are part of groups that contract with hospitals. This arrangement is nice for the doctor–no office expenses, regular hours, no on-call, but it may not be so good for the patients, or for Medicare.
As the blogger reports, there are some research studies that indicate that hospitalists are not always beneficial. First and foremost, there is a lack of continuity, because the hospitalist has likely never seen you before. The study also reported that hospitalists save money for hospitals, because patients are discharged sooner, but overall hospitalists cost Medicare money. Why? Because those patients who are discharged sooner are often discharged too soon, and end up back in the emergency room or hospital. The study also found that patients seen by hospitalists were more likely to be discharged to nursing homes, while patients seen by a PCP, who is familiar with the patients’ home and support situation might be more open to discharging the patient home.
The thing to take away from this is that we have to advocate for what is in the patient’s best interest, and provide as much information as possible to all health care providers. We can’t just assume that the doctor knows best, particularly if the doctor doesn’t know you at all.
If you’ve looked at the website today, you may have noticed the addition of Sandra Webb to our team. Sandra is an attorney with over 25 years of experience in a variety of settings. Like so many of us Baby Boomers, she has experienced being a caregiver for an older family member, so she comes to Katten & Benson with an understanding of what so many of our clients and their families are experiencing.
Sandra lives in the Glen Rose area, and she will primarily meet with clients in that area. We’re excited about Sandra’s affiliation with us, as well as the opportunity to serve people in the Glen Rose and surrounding areas.
Here’s something I never really thought about before: There is no uniformity in how prescription medication directions are written. An article I read recently talked about this problem, and how it contributes to people not properly following medication regimens. Here is an example:
Let’s say you have 2 prescriptions. One bottle says to take one pill every 12 hours. The other bottle says to take one pill twice a day. Do you take them at the same time? In many instances, you can, but a lot of people will take them at different times, thus making a harder schedule. Now, if you only take 2 medications, this might not be all that hard to manage, but what happens when you take 6 medicines?
Since reading the article, one thing I noticed about my own prescriptions is that there is no uniformity in the warning labels. I recently got a prescription refilled at the same pharmacy that’s been filling it for years. The old bottle had 3 different warning labels on it: warning of dizziness, warning not to smoke while taking the medication, and warning of headaches. The new bottle had no warning labels at all. Now, I’m pretty sure the medication didn’t change, so why did the labels change?
It’s really important to carefully review your medications and the directions, and if you do have any questions about how to take them, talk to you doctor or your pharmacist, because they are the people who can help you simplify and understand the directions.
As I write this, I am enjoying ample air conditioning, after almost 3 days of no air conditioning at the office. Yes, our only 3-year old air conditioner went out last Friday, and was not repaired until late yesterday. With the prospect of 100+ degree temperatures for the next week, it’s time to take a moment and make sure that your older adult friends and family members are cool and comfortable.
Many older adults are cold natured, and it’s not unusual to go into an older adult’s home and find it quite warm, with the thermostat set in the 80’s. As long as the thermostat is set, and the air conditioner does come on when it gets too hot, all is well. But if something goes wrong, then the house could dangerously hot before the older adult realizes it. That coupled with the fact that a lot of older adults already skirt dehydration (due to diuretics, stress incontinence, etc.), and there could be a hospitalization in a matter of hours.
So, make sure thermostats are working, get fans if necessary, encourage liquids, and check on people frequently to prevent more serious problems.
Elder abuse is an often hidden, but serious problem. Elder abuse includes physical abuse, sexual abuse, neglect and self neglect, and financial exploitation. To raise awareness of elder abuse, wear purple on June 15, World Elder Abuse Awareness Day. If you suspect that an older disabled adult is being abused, please report it. If it is a life threatening situation, call the Abuse Hotline at 1-800-252-5400. You can also make online reports at www.txabusehotline.org. Your report will be confidential. If you suspect that a resident of a nursing home is being abused by facility staff, call 1-800-458-9858.
In this plugged-in world we live in, we are constantly reminded of the perils of identity theft and financial exploitation. But what we often forget is that you don’t have to be on-line and plugged in to become a victim. Many older adults are at risk to be victims of financial exploitation, sometimes because they have dementia, and sometimes because they just can’t say no to seemingly harmless, helpful people.
Baylor College of Medicine has developed a Financial Concerns Checklist, and while it was probably meant to be used by doctors and other professionals, I think it can be helpful for friends and family to identify possible problems. Here are some of the statements from the checklist:
- I have trouble paying bills because the bills are confusing to me.
- I don’t feel confident making big financial decisions alone.
- I don’t understand financial decisions that someone else is making for me.
- I give loans or gifts more than I can afford.
- My children or others are pressuring me to give them money.
- People are calling me or mailing me asking for money, lotteries.
- Someone is accessing my accounts or money seems to be disappearing.
Here are some other items on the checklist that indicate possible concerns:
- Social isolation
- Dependence on another to provide care
- Financially responsible for adult child or spouse
- Alcohol or drug abuse
- Depression or mental illness
Unfortunately, there may be no easy way to intervene in a situation where financial exploitation is suspected. If the older adult has dementia and they have previously appointed someone to act as power of attorney, then this is the time for the power of attorney to step in and take control of the finances. In some instances, however, it may be the family or power of attorney who is doing the exploiting. A referral to Adult Protective Services can be made, but it can be really hard to prove that the older person did not willingly give money away, especially to a family member. If the exploitation seems to be coming from non-family members, something like a money management program, like the one provided by Guardianship Services, might be an option. If all else fails, then guardianship may be necessary.