Choosing a Wearable Medical Alert System
Choosing a Wearable Medical Alert System
You or a loved one recently had a stroke and is returning home after a long stay in the hospital and in-patient rehabilitation. The care providers assure you that you will be fine returning home, but you still worry. How can you make sure your parent is safe at home?
A medical alert system is a device that can connect the user with help when activated, either at the press of a button or if a fall is detected. These devices can be life-saving in case of emergency, and can give seniors independence, and their loved ones peace of mind. One might assume that a smartphone or digital assistant is sufficient, but unlike cell phones, medical alert systems stay on your body so that you always have access to it, and unlike Alexa and Google home, medical alerts can call 911. So if you do decide to buy a medical alert system, you’re going to want to choose a quality system; since you rely on them in times of emergency, you want to know it will work. But how do you choose?
Consumer Reports suggests answering three questions before choosing a medical system. The first is, do you want a home-based or mobile system? The answer depends on your lifestyle and preferences. The second question is, should your system be monitored or not? Consumer Reports only recommends monitored systems, which means that the call button connects you with someone at a 24/7 dispatching center, rather than automatically dialing a friend or family member from a programmed emergency call list. And finally, should you add a fall-detection feature? It’s a relatively inexpensive add-on ($15 or under per month), but the technology may not be perfect; it may register something as a fall that isn’t, such as stumbling or dropping your phone.
With these choices in mind, one might look at the systems Consumer Reports recommends, or those on The Senior List has a Recommended list. The Senior List makes its recommendations based on four criteria: (1) works as advertised or better, (2) customer service, (3) pricing, and (4) easy to cancel contracts. For 2020, their top 9 medical alert systems were Bay Alarm Medical, MobileHelp, Medical Guardian, Philips Lifeline, LifeFone, LifeStation, ResponseNow, QMedic, and Alert1. Consumer Reports also recommends Bay Alarm, LifeStation, Medical Guardian, MobileHelp, and Philips Lifeline, but they also recommend GreatCall Lively Mobile, Life Alert, Medical Alert, and Rescue Alert.
Bay Alarm is ranked best overall, at $19.95-$29.95 monthly cost (the lowest on this list!) and no equipment fees, with landline and cellular in-home options, a mobile option with 4G LTE coverage, and an in-car medical alert, among other features. The equipment is easy to install and its range of products are appropriate for various situations without being overwhelming. They don’t require long-term contracts, and they allow you to try it for 30-days risk-free.
MobileHelp is also consistently high quality, in terms of both equipment and customer service. They offer cellular in-home medical alert systems, mobile and GPS systems, and even jewelry or smartwatches. They offer extras like fall detection, medication reminders, and vital sign monitoring. Costs start at $19.95 monthly (with a one-time $49.95 fee for the in-home system, unless you choose an annual plan, in which case that fee is waived). They also have a deal to buy two systems, which is good for couples. They don’t require long-term contracts, and they offer flexible pricing plans.
Finally, before making your purchase, check return policies carefully, especially if you have hearing loss. Read more about The Senior List’s top medical alert systems, including the Medical Guardian, Philips Lifeline, LifeFone, LifeStation, ResponseNow, QMedic, and Alert1, here. Consumer Reports also covered medical alert systems, available here.
If you or a loved one is living at home with care, it is important to consult with an elder law professional to make sure a proper plan is in place that covers your loved one’s care needs and financial needs. We help families plan for the possibility of a loved one needing significant care and would be happy to talk to you about your particular situation. Just give us a call at 1.800.6605.7564 or email us at email@example.com.
84+ billion in annual tech spending for those aged 50 or older by 2030
84+ billion in annual tech spending for those aged 50 or older by 2030
It isn’t just assisted living and nursing home workers employing the latest technology to improve caregiving for elder Americans. According to an AARP Survey upwards of 84 billion dollars will be spent annually on technology products for personal self-care use by the 132 million Americans aged 50 or more by the year 2030. While 84 billion dollars is a lot of money it does not account for additional discretionary spending for technology purchases such as gifts for children or grandchildren; therefore the number of dollars spent on technology by seniors could be significantly higher than already projected. A significant portion of the personal needs purchases will be to address privacy and security issues as fewer than one in four senior adults trust online retailers, telecom service providers, and even the federal government.
Though concerns regarding privacy are in the forefront of technology purchasing, counter-intuitively another significant portion of projected purchases will be for personal home assistants such as Google Home or Amazon Alexa, which allow passive “spying” on home environments. Currently, of those Americans, aged 50 plus, one in seven owns a personal assistant and the projected sales increases in this demographic is growing at a very rapid pace. Additionally, technology products such as smartphones, smart TVs, smart cars (nearly 1 in 4 view advanced driver assistance technology like lane change monitoring, collision avoidance, automatic parking, and emergency braking as important) and virtual reality devices are also increasing as are smart environmental control devices for thermostats, lighting, refrigerator door and stove monitors, and front doorbell audio/video capabilities.
Upwards of 23 percent of aging adults are embracing the benefits of lifelong learning through technology-enabled classrooms, certification programs or tutorials which may, in turn, lead to seniors providing more online content and blogs specifically geared for aging Americans written by aging Americans. Sixty-three percent of seniors use computers or smartphones to play games and 57 percent watch TV or movies while more than 90 percent use technology to stay in daily contact with family and friends. Already, a full 13 percent of 50 plus adults use virtual reality, and it is increasing at a healthy 4 percent a year despite it being a relatively new technology for commercial use. Current smartphone and computer device usage for those ages 50 to 64 rank the same as the average American; 83 percent employ smartphones while 91 percent use computers.
The number of new consumers in the American population is growing at less than 1 percent a year which means that the aging American market is a sweet spot of spending for corporations seeking to generate revenue. The fact that these elder Americans are online where their information can be absorbed, data mined, and target marketed will increase profits outside of the simple purchase of a technology product. Sales of technology products are now being monetized post-purchase by collecting personal data and reselling the information to advertisers, marketers, and even government agencies.
By 2030 it is projected that there will be more than 132 million Americans aged 50 plus which is an increase of more than 17 million in that demographic. These Americans represent the bulk of purchasing power as well as the growing need to address successful aging strategies through the implementation of technology products. There are just not enough younger people to be employed in the caregiver industry to address all of the future aging needs the baby boomer generation represents.
Aging Americans can expect a lot of commercial technology products specifically tailored to their needs in the coming years because they have so much money to spend. Seniors want life-enhancing and protecting technology products, and corporations want to make money so the senior technology product market will become an increasingly important segment of the technology sector.
Technology is becoming increasingly popular as a means for providing or delivering care to seniors. We help seniors and their families plan for the possibility of needing care in the future, and would be happy to discuss how we can help you do the same by calling us at 1.800.660.7564 or by emailing us at firstname.lastname@example.org.
A simple blood test can check for Alzheimer’s disease before symptoms emerge
A simple blood test can check for Alzheimer’s disease before symptoms emerge
Alzheimer’s disease is becoming more prevalent among aging Americans, and there are more aging Americans than ever before. Alzheimer’s disease has three typical biomarkers: plaques of beta-amyloid protein, tangles of tau protein, and loss of connections in the synapses that communicate information between brain cells. Now a simple blood test may be able to detect early signs of Alzheimer’s years before any symptoms, like memory and thinking decline, become apparent. The test involves the identification of changes in levels of NfL a neurofilament light chain protein found in the brain. This protein is part of the internal skeleton and resides inside neurons and brain cells, but when damaged or dying NfL leaks into the cerebrospinal fluid (CSF), it becomes circulated into the bloodstream. CSF provides essential mechanical and immunological protection to the brain inside of the skull.
Prior testing to determine elevated levels of NfL in the cerebrospinal fluid involved a lumbar puncture or a spinal tap which is a procedure many people are reluctant to undergo. Still, this raised level of NfL is a reliable indicator that brain damage has occurred and that the person is at an elevated risk of Alzheimer’s pre-symptomatic stages. Testing of NfL “…could be,” says co-first study author Stephanie A. Schultz, who is a graduate student at Washington University, “a good preclinical biomarker to identify those who will go on to develop clinical symptoms.”
Recent data from the National Institute on Aging Alzheimer’s disease fact sheet estimates Alzheimer’s may rank as the third leading cause of death for older people following heart disease and cancer. It is also the most common form of dementia among seniors aged 65 or more. A simple blood test can detect the future state of you and Alzheimer’s but do you want to know? Currently, there is no cure for the disease, and depending on the levels of optimism an individual displays, knowing their NfL status could be a blessing or a curse.
The blood test gives pre-diagnosis years ahead of the onset of symptoms. There is a percentage of seniors who would find this information disheartening and feel burdensome and full of worry for what is about to come. These individuals can receive protection from knowing at their request if the information would make them fearful and angst-ridden. Other seniors might want to have a pre-diagnosis to relish the time that they have left with full faculties. They may want to get their affairs in order, handling day to day living choices and extension of life choices when they are no longer mentally competent to do so. Many components divide the two camps of thought; wanting or not wanting to know. Family structure, faith, financial independence, education level, and general health and well-being typically play a factor in the decision.
What of the family who may want or may need to know of the future advent of Alzheimer’s to plan for the care of their spouse or parent? As a spouse and as a child, it is crucial that medical directives be in place for when their loved one can no longer make a sound decision but can be comforted by the fact that they participated in the planning years before. A spouse must prepare when their loved one enters a full-time care facility they may no longer recall their marriage and their spouse and unknowingly, may strike up a “relationship” with another resident. Retired Supreme Court Justice Sandra Day O’Connor encountered this with her husband and famously became involved in raising awareness of Alzheimer’s disease. Subsequently, she was diagnosed with Alzheimer’s disease in 2018 and retired from public life.
Outside of the emotional realm of not having an Alzheimer’s stricken spouse or parent recognize who you are there is a substantial financial component to caring for individuals with Alzheimer’s. For practical and economic reasons, a family should be able to establish the biomarker for a loved one’s likelihood to develop the disease through this simple blood test. To that end, health information is private and protected by law. To ascertain your spouse or parents’ risk of Alzheimer’s requires conversation, acceptance of the blood test, and careful planning with elder counsel for proper legal documentation.
Contact our office today and schedule an appointment to discuss how we can help you with your planning, or call us at 1.800.660.7564 or email us at email@example.com.
Veterans, home health care and technology
Veterans, Home Health Care and Technology
The Department of Veterans Affairs (VA) has become an unlikely and innovative pioneer in the quest to provide cost-effective, quality in-home care for veterans. Although the agency has long been mired in controversies surrounding its programs, particularly arbitrary caregiver dismissals, the home health services sector of the VA has long been touted as an overall success story. As Thomas Edes, director of comprehensive geriatrics and palliative care programs for the VA puts it, “We’re working in this environment of challenging budget constraints, and at the same time, we’re a very mission-driven organization. Put those together and what happens? That really pushes us to innovate.”
This innovation has seen home-based primary care for veterans quadruple since 2000, and all VA medical centers throughout the US now have a palliative care program as well. The VA Medical Foster Home program care has expanded from a pilot to a national program, recognized in at least 45 states and providing veterans housing as well as in-home care. These success stories are great news for veterans and a must for the Veterans Administration partially because the median age of a veteran is now 64 and the US aging veteran population is growing even faster than the senior civilian population.
It is not just the “newcomer” seniors straining the VA health care system. Nationwide the 85 plus population is on track to increase 70% from 2000 to 2020 according to the US Department of Health and Human Services. The overall unsustainability of the US health care system has forced the hand of the VA, and there is no more cost-effective way than through subsidized, at home family and community-centered health care and technology to meet veterans’ care needs.
The Official Blog of the U.S. Department of Veterans Affairs reports that Telehealth is revolutionizing veteran care and providing high-quality treatment for them. The VA Video on Demand is delivering convenient, accessible health care particularly to those 24 plus percent of veterans who live in rural and remote access locations. Telehealth is also important for those veterans who are disabled. Although a veteran might live in a city they might be unable to get themselves to a medical center for an appointment.
Assisted living technologies for veterans include assistive mobility equipment which is an ever-expanding category including wheelchairs, all-terrain vehicles, exoskeletons, and in-home ceiling track mobility systems continue to be refined and specialized to meet the individual veteran’s needs. The Veterans Administration awards grants to develop technology to assist veterans and service members in modifying their homes. Adapted computer access and electronic aids to daily living and environment control units (personal assistants) provide customized interactive abilities for veterans.
Electronic cognitive devices help veterans who struggle with activities of daily living (ADL). These devices include personal digital assistants (PDAs), smartphones, pocket personal computers (pocket PCs) and other handheld devices, global positioning systems (GPS), reminder watches, pagers with reminder features, and digital voice recorders. The use of these devices helps a veteran stay on schedule with medications as well as stay connected with family, friends, and their medical monitoring community. Those veterans with Post Traumatic Stress Disorder (PTSD) are further helped with their ADLs when robots with artificial intelligence (AI) are introduced into their environment. These AI “tech bots” are capable of reading human facial expressions and can identify when a veteran is feeling particularly stressed, isolated, angry, or depressed. The robot can upload the information to the veteran’s caregivers thus alerting them to the need for human intervention. Wearable sensors can also alert a caregiver or medical professional when vital signs are outside of a normal, healthy range.
The VA will provide a payment to disabled veterans toward the purchase of a car or other transportation and additionally will pay for adaptive equipment, repair, reinstallation or replacement of necessary equipment due to disability. If a veteran has lost the use of at least one foot, hand, or has a permanent impairment to their vision or severe burn injuries or immobile joints that their limit mobility the VA will help to fund the adaptation of the vehicle to make it fully operational to the veteran. The same holds with regards to some sports and recreation equipment as well.
While the latest technology brings benefits to all seniors opting to age in place, the veteran community is especially helped. Many veterans would like the luxury of aging without combat or noncombat injury so inherent to military service. Some of the aging in place obstacles they must overcome are extreme, commensurate with the injuries (psychological and physical) they have endured. Navigating the benefits that are available to a senior veteran is complicated if you are not well versed in the process. Getting enrolled in the correct program and receiving benefits can also be a lengthy process, so it is best to seek professional advice before wasting valuable time.
If you have questions or would like to discuss your situation, please don’t hesitate to reach out to us at 1.800.660.7564 or by emailing us at firstname.lastname@example.org.
Leaving Well: A Step-by-Step Process
Leaving Well: A Step-by-Step Process
Contemplating our own death is one of the hardest challenges we will ever have to face. Yet, if we want our dying to be meaningful and merciful, it is imperative that we think about it while we still can. Most of us want to die at home, in a familiar and peaceful setting surrounded by loved ones. We would much rather not spend our last moments in an emergency room or ICU, with strangers futilely pounding on our chests and our families relegated to the waiting room.
With those two alternatives in mind, we need to do all we can to keep control, as much as possible, of decisions that need to be made long before our final moments. We need to think carefully, well in advance, about what makes life worth living, and where pain and limitation have so eroded that quality of life that we would prefer not to go there.
These are notoriously difficult questions, but it is vital to address them anyway. For example, Terri Schiavo spent nearly half her young life unconscious in a condition known as a “persistent vegetative state,” being kept alive by a feeding tube. Her husband and friends claimed that before her severe brain injury, she said that she would not want her life sustained by machines. Unfortunately, she never put that wish in writing. On the other side, her devout family and right-to-life supporters insisted that she be kept alive despite her dire condition. After protracted litigation, Ms. Schiavo’s husband prevailed, the feeding tube was withdrawn, and, fifteen years after she was injured and never having regained consciousness, she was finally allowed to die.
Since her passing, the law has evolved nationwide to encourage us all to document final wishes, to avoid the anguish and uncertainty of Ms. Schiavo’s situation. There are a number of documents available in your state for that purpose. The umbrella term for these is “advance health-care directives.”
It’s our job as lawyers to help you sort through the various directives needed to express your wishes. Here is a step-by-step guide to begin the conversation about final wishes, and to understand which document does what when.
1. If you are over the age of 18, appoint a health-care agent to speak for you when you can’t.
Decide who, among those who know you well, is best suited to take on this responsibility. That person must possess good communication skills, remain calm in difficult situations, and be able to deal flexibly with complexity that might arise in reconciling your wishes with available medical options. Depending on which state you live in, your agent can also be called a “health care proxy.”
Sit down with that person and discuss your wishes in various scenarios. This is not an easy conversation to have, but there are guides available to help you. Visit “The Conversation”
and download the starter kit.
2. Health Care Power of Attorney (HCPOA)
Once you have had that conversation, visit your lawyer to name your agent formally in an HCPOA document. HCPOA conveys legal authority on your agent or proxy to express your health-care decisions when you are unable to. Here in Florida we refer to this document as a Designation of Health Care Surrogate.
3. HIPAA authorization
Your agent or proxy will also need access to your otherwise-private medical information. This is best done by a standardized document that complies with the federal Health Insurance Portability and Accountability Act (HIPAA). Without this authorization, your agent will be unable to obtain the medical information necessary to exercise the authority you want him or her to have.
Now armed with your agent and the HCPOA and HIPAA documents, you will know that if you were to meet with an accident or lose consciousness, you have chosen and empowered an advocate to speak for you. You should review and update these documents every five years or so.
The next three documents are important at the end of life. All these documents should stipulate that you desire comfort care, to keep you clean and as pain-free as possible. Remember, though, that you must create these documents while you are still able to know and communicate your wishes, so it’s best to do the next two documents at the same time that you do your HCPOA and HIPAA.
4. Living Will (also known as Physician’s Directive)
This document is for use when you are not enjoying quality of life. Either death is imminent; you are in a persistent vegetative state; or you are permanently unconscious, permanently confused, or unable to care for yourself. If you have no awareness of others; can’t remember or understand or express yourself; or are unable to move, bathe, or dress yourself, it’s advisable to have expressed, in advance, the kind of treatment you want to receive or not receive.
A living will expresses your choice as to whether you do, or do not, want artificial measures that will merely prolong your life but not improve it. Those measures, among others, may include CPR if your heart stops, or breathing or feeding tubes, or repeated courses of antibiotics or chemotherapy.
You may also require physicians, and not your agent, to be the ones to decide whether to cease life-prolonging procedures as you would like. This decision will relieve your agent from the heavy responsibility of making that irreversible choice.
Living wills are legal in almost every state. Ask your lawyer. Don’t make this kind of document yourself. Otherwise you risk that the document may be misinterpreted, with drastic consequences.
5. Specialized Directives
Medical decision-making varies depending on specific health conditions, so specific directives may be tailor-made for those conditions. For example, people suffering from advanced dementia benefit from a directive, in addition to the HCPOA or living will, specifically requesting that hand-feeding be ceased when the person can no longer speak, recognize loved ones, or move purposefully. Otherwise, caregivers are obligated to cajole or demand that the patient be fed by hand, taking advantage of a primitive reflex to open the mouth. This risks that the person may inhale the mush instead of swallowing it, in some cases causing pneumonia.
For this kind of condition, ask your lawyer to prepare a specific directive tailored for advanced dementia, using the directives created by End of Life Washington
or End of Life Choices New York.
If, however, you suffer from a neurological illness like Lou Gehrig’s disease (ALS) or advanced Parkinson’s, even though most of us would decline mechanical treatments, those same treatments may be important aids to preserve quality of life for people with those conditions.
Again, remember that you must create these documents while you still have the capacity to communicate your wishes. Living wills should be reviewed every six months, because wishes can change depending on the progress of the illness.
6. DNR or POLST or MOLST
This is a brightly colored, short-form document that is primarily intended for emergency responders when the patient is frail and is likely to die within a year. It is designed to be immediately recognizable by hospitals and EMS personnel, to express that when the patient is unresponsive, cardio-pulmonary resuscitation (CPR) and other aggressive treatments are desired or not desired (DNR).
This document should be filled out in consultation with the patient’s physician. The acronyms stand for “physicians’ orders for life-sustaining treatment” or “medical orders for life-sustaining treatment.” Many states provide for this kind of document.
7. Make Your Documents Known
When it comes time to use your documents, they must be readily available. Give a copy of them to your agent or proxy, make sure they are included in your medical records, and, if you are in need of the POLST or MOLST, post it beside your bed or on your fridge where EMT knows to look for it. If your documents can’t be found, or if your agent or family don’t understand them or ignore them, you will have spent your time, effort, and money in vain. Here at Covert Law we provide all of our clients with a secure, encrypted online Client Portal to which you can give access to your helpers and family, and where all of your important legal documents and health care materials are stored. See: https://www.covertlaw.com/client_portal/client_portal.php
But if all goes according to your wishes, you will have done your best to create a good death, one that is as meaningful as possible for all concerned. If we can assist in helping you with any of the documents above, we would be honored to do so. As always, if you have any questions or concerns, please feel free to contact us at Covert Law by calling 1.800.660.7564 or email us at email@example.com.
The Internet of Medical Things
The Internet of Medical Things
The Centers for Medicare and Medicaid Services are looking to the future of the US health care system, and it is projected to be overloaded with seniors needing medical care. In 2010 the US elderly population accounted for about 13 percent of the US population yet accounted for 34 percent of the total health care expenditure. That percentage will continue to increase because of increasing longevity in the growing senior community. Depending on the region, estimates about the future costs of elderly health care may more than double between the ages of 70 and 90.
Government medical programs and services, insurers and manufacturers are tasked with finding ways to reduce the enormity of health care costs in particular as it pertains to senior care needs solutions. Lower costs and increasing efficiencies are the mandates to address the looming potential expenditure crisis. Enter the Internet of Medical Things (IoMT).
Digital technologies and their application to senior medical needs offer the best hope to address existing and future needs. You may have already read about the Internet of Things (IoT) which is a network of devices such as home appliances, software actuators, and vehicles including wheelchairs, not traditionally extended to internet connectivity. The IoMT is similar but reserved for a collection of medical devices and their applications that connect to healthcare information technology systems through online computer networks. The medical devices are digitally linked to Wi-Fi that allows machine to machine communication and throughputs of data collection. The captured data can be stored and analyzed all the way from individual to metadata levels. The importance of controlling senior medical costs now and in the future cannot be understated.
Vitals-tracking wearables are already well-known medical devices. These devices monitor everything from daily physical activity levels, hypertension, cardiac ailments, diabetic levels and more. The devices send vital signs over the internet to medical monitoring staff who can alert health care providers when vital signs are out of the patient’s range of normal. Vitals-tracking wearables are also used in assisted living facilities, nursing homes and hospitals to help nurses and off-site physicians continuously monitor seniors’ vital signs passively.
Medication adherence tools are an electronic reminder system for proper consumption of prescription and other medications. These tools reduce the chances of missing or overdosing on medications. Medical adherence tools can decrease the number of hospitalizations or 911 calls prompted by the potentially serious consequences of improper dosing of medications thus saving costs on unintended medical attention.
Virtual home assistants are increasingly found in senior homes providing daily assistance such as environmental controls, medical advice, calendar reminders, as well as social connections to family and friends which reduces the risk of isolation and therefore can reduce depression. All of the benefits that a virtual home assistant can provide considerably reduce unnecessary life stresses and health problems which reduce costs.
Biomarker portable diagnostic devices are a staple in the senior age group as they need to be tested more frequently than most segments of the population. Rather than a trip to a pathology lab for blood testing et al., these smart and portable diagnostic devices can allow the senior to perform testing in the comfort of their own homes and get results that are formatted to be instantly shareable with medical care providers. The convenience factor and proactive nature of these devices allow for more frequent testing which can lead to early disease detection and its treatment which lowers the costs of health care.
Emergency assistance, fall detection, and “navigation guidance” back to their residence for dementia patients are all part of the personal emergency response systems available to seniors. Some of the fall detection systems are now equipping seniors with sensor belts that can identify a change in gait and can even deploy airbags to prevent injuries due to unintended falls. Fall-related health care costs can be staggering as it can include hospitalization in the event bones are broken, or a severe head injury occurs. These fall detection systems will trigger alerts to designated emergency contacts in the event of fall, emergency medical need, or re-homing of dementia or Alzheimer patient.
Seniors with disabilities including sensory and cognitive impairment can use disability assistance tools to control selection and volumes of streaming music, on-off switch programs for televisions, lights and thermostat controls. Many of these systems are being developed for voice recognition to reduce the need to interact with screens and buttons. Some of the existing tools include customizable colored buttons installed in the residence of the senior that alerts them to perform daily tasks like brushing their teeth. Upon completion of the task, the senior presses the button and the device activates the next task in the customized sequence. When a senior can manage their environment without the constant need for supervision, it lowers health care costs.
Nearly everyone is familiar with the concept of the smart implant known as the pacemaker that controls the heart rhythm of the wearer and can communicate patient data via smartphone apps to their physician. Now there are newer smart implants. These include glucose sensors, dedicated readers, smart knee, shoulder and spine implants, and orthopedic implants which can communicate post-surgery performance. These implants provide real-time data of patient condition to medical professionals who quickly assess if early intervention is required when a problem arises thus lowering medical costs.
Smart home senior facilities have arrived. Residences receive wrist-worn wearables that can free up care providing staff as the devices are tied into machine learning and predictive analytics determining insights into deviations from the senior’s daily routine. Some are designated into three types of color-coded alerts such as red for night wandering or potential fall, orange for changes in the routine of daily living such as irregular eating, and yellow for environmental issues such as leaving a stove on or a refrigerator open. This technology allows health care professionals to monitor patients while multi-tasking other facility operational tasks saving health care costs. Similarly, family caregivers can use remote monitoring tools that enable oversight without having direct contact with their loved one. Alerts are sent when daily routines are detected to deviate from the norm allowing the family member to contact their senior to ensure all is well. Remote monitoring tools can help family caregivers remain at work and on task in their own lives while still adequately watching over their loved one.
While the internet of medical things holds great promise to curb excessive increases in senior health care costs, there are some cautionary tales. What if an internet service provider “goes down” and no Wi-Fi is available to maintain connectivity to health care professionals? Lately, the number of natural disasters in this country calls attention to what will happen to senior digital monitoring when the lights go out during a fire, flood, hurricane or tornado. Will there be a backup generator to keep the devices online? Will there be anyone in the affected disaster zone online to interpret the medical data a vital tracking wearable uploads? What if the medical device fails for mechanical reasons? Can all aging seniors cope with this level of technology? While these remain potential disaster scenarios the more massive disaster is not addressing the overwhelming costs of senior health care for an increasingly elderly population. The internet of medical things is the logical, efficient, and effective solution for now.
If you have questions about what you have read or would like to speak with us about you or a loved one’s legal needs, please don’t hesitate to reach out at 1.800.660.7564 or email us at firstname.lastname@example.org.
Neuroscientists’ Sleep Recommendations for Women
Neuroscientists’ Sleep Recommendations for Women
Sleeping is one of the most important things you can do for your overall health and well being. The amount of sleep you get is particularly crucial if you are a woman – new studies indicate the traditional recommendation of eight hours is not enough. If you are a woman aged 50 or older, you will likely live longer than the men in that same age group. A longer lifespan presents additional challenges to staying healthy, and as a woman, if you do not get enough quality sleep, it will negatively impact your health.
Biological differences between the genders play a role in sleep needs. Neuroscientist research has concluded that women need more than eight hours of sleep each night or they are not well rested. The general reason for this is that the female brain is more active than the male counterpart and requires more rest to recover and repair itself from the damage that was done throughout the day.
While you sleep many things are taking place; the body can recover and repair itself from the happenings of the day. Compounds are being synthesized for energy while cells and organs get replenished. The Mayo Clinic reports that lack of sleep increases the risk of daytime sleepiness, weight gain, heart disease, and reportedly forms of dementia like Alzheimer’s. Alzheimer’s disease is thought to be caused by an excess of amyloids (aggregates of proteins) in the brain. As women go into a deep state of sleep, these proteins get cleared from the brain. There is a connection between the quality and quantity of women’s sleep and a healthy brain. Nearly 66% of people living with Alzheimer’s are women, and surveys show that 40% of adult Americans get less than 7 hours of sleep per night – the overall average amount of time spent sleeping for all adult Americans is 6.9 hours. Lack of sleep for women has disastrous consequences for their health.
Proper hours and quality sleep decrease stress levels, which is beneficial to cardiovascular health. Good sleep affords women better attention capabilities, better memory function and may increase creativity. Sleep also helps the body to maintain a healthy weight as women with proper rest lose more fat, provided they are eating healthy foods. Plenty of sleep also supports a woman’s skin and overall appearance. The adage “beauty rest” is a real thing.
There are some things that women can do to help improve the quality of their sleep. Exercising on a daily basis is key to proper rest. Turning off the television and putting away the cellular phones at least one hour before bedtime allows your brain to wind down to a more restful state and gets you away from the blue light emissions that can affect the quality of your sleep. Avoid alcohol and coffee before sleeping and develop a healthy bedtime routine. Have a set time for lights out and stick with it. Make sure your mattress and pillow suit your sleep needs.
Women require more sleep than their male counterparts. Sadly, many women may not know this or have a feeling of guilt if they take the time to sleep more. However, a well-rested woman is capable of being more productive during her day than a tired one. A well-rested woman has a much better chance of being healthy and disease free. It is essential to take the proper steps to ensure you or the women in your life are getting enough sleep. Taking care of your physical self through adequate sleep is one of the most important things a woman can do – it can help you remain healthier as you age. To have a successful and enjoyable life in your later years, plan for sleep and make it a priority to get enough of it. Planning for your later years and striving to be fit both physically and mentally are a necessity for successful aging. Women have unique needs that must be addressed. Contact our office today and schedule an appointment to discuss how we can help you with your planning and care by calling 1.800.660.7564 or by emailing us at email@example.com.
The Surprising Health Risks of Hearing Loss
The Surprising Health Risks of Hearing Loss
The findings from a 10 year study by the Journal of the American Medical Association have reported a link between hearing loss and health risks. The risks include a 50% greater risk of dementia, a 40% greater risk of developing depression and a nearly 30% higher risk of accidental falls. While hearing loss is becoming more prevalent in younger people due to the use of earbuds and noise pollution, it is the elderly population who are more quickly and significantly affected by adverse health risks because of their hearing loss.
There is a wide range of reasons that account for hearing loss. Some are genetic while others include noise exposure, medications, head injuries, and infections. While hearing loss is a frustrating experience for those who have it, along with their loved ones, the worst option is to ignore the condition. The sooner your hearing is tested, the better your ability to proactively save yourself from associated health risks due to hearing loss. According to John Hopkins University, brain scans indicate that loss of hearing has even been associated with more rapid rates of brain atrophy.
One of the first symptoms of hearing loss is trouble detecting high-pitched or soft sounds. This form of hearing loss is associated with stereocilia, which is the damaging of the fragile hair cells that convert sound waves into electrical signals your brain can understand. For example, high-pitched sounds might include children’s voices while soft sounds include phone conversations or background noise in a restaurant. If you are having any trouble hearing these softer or high-pitched sounds, make an audiologist appointment for a hearing assessment to get a baseline reading. Loss of hearing contributes to social isolation and the longer you wait to address hearing loss, the greater the risk of cognition problems. Meaning, you may hear the words but not be able to process their meaning.
Other than cost, there is no downside to hearing aids anymore. They are discreet, easy to learn how to use, and professionally adjustable over time to compensate for increased hearing loss. Once you factor in the cost of a potential fall, increased risk of dementia, social isolation and depression, the cost of a hearing aid is comparatively minimal. If your hearing loss is profound already, there are cochlear implants, which are devices implanted into the inner ear to stimulate the auditory nerve. These devices can help to restore sound perception in adults with more extreme hearing loss. Your walking motor skills are dependent upon your hearing to pick up subtle cues that help you maintain your balance. Hearing loss mutes these critical cues and makes your brain work harder to pick up sounds, which can then interfere with some of the mental processes needed for safe walking.
While it is not yet proven that treating hearing loss can prevent dementia, unintended falls, or social isolation and depression, it is important to investigate as more than two-thirds of adults over the age of 70 have significant hearing loss that can impact their everyday quality of life. Older adults with hearing problems left untreated also incur substantially higher overall costs of health care. At the ten-year mark of untreated hearing loss in an older adults, the incidence of hospitalization increases by 50% or so. There are also higher rates of hospital readmission and an increased likelihood for emergency room visits when compared to those elderly adults without hearing loss.
Communication between patient and health care provider is also problematic for those adults with hearing loss. A patient has less participation in their health care plan and can often become confused as to their diagnosis and possible courses of action for treatment. Also, following instructions post appointment or hospital discharge can be problematic. Costs associated with untreated hearing loss have prompted both health care companies and insurers to find better ways to serve patients with hearing loss.
Nearly 27 million Americans age 50 or more have hearing loss while only one in seven uses a hearing aid or implant device. Hearing is often the most overlooked of the five human senses: taste, sight, touch, smell, and sound. Your ability to hear is incredibly important and the longer you put off addressing a hearing problem, the greater the possibility of associated adverse health events. Make good hearing part of your overall plan to age successfully. Like retirement planning and elder law planning, the sooner you address the issue, the better the outcome will be. Contact our office today and schedule an appointment to discuss how we can help you with your planning by calling us at 1.800.660.7564 or by emailing us at firstname.lastname@example.org.
Senior Living Options When Care is Needed
Senior Living Options When Care is Needed
As Americans age, living options can become a concern. Available options are tied to the resources a senior has to cover living costs, and vary widely in cost, assistance, and care provided. In addition to budget considerations, seniors must also realistically consider the needs they have and what senior living option best fits those needs.
Nursing homes, or skilled nursing facilities, are one option for senior living. These facilities are for seniors who can no longer live independently. They provide care for seniors with illnesses or mental conditions that cause them to require monitoring and medical care on a full-time basis. For example, many nursing home patients have dementia, are confined to a wheelchair, or spend most of their time in bed. Their conditions require that medical attention be available around the clock.
Nursing homes also provide the option for short term care, where patients come and stay for a limited time after major medical events such as strokes or heart attacks. In these facilities, the residents generally live in semi-private rooms and all meals are provided. Medicare may help cover the cost of skilled nursing facilities, assuming the resident meets certain financial requirements. Long term care insurance may also pay for nursing home care. Otherwise, a nursing home resident pays privately, which can often bring financial hardship upon the family. As a result, many families work with an elder law attorney to discuss care options as well as payment options for that care.
Assisted Living Facilities
Another option for senior living is assisted living facilities. These facilities are ideal for seniors who are still independent but may need some assistance with activities of daily living, as well as meals, cleaning, or other daily self-care tasks. These facilities usually offer a more private living conditions. Since residents may be fairly independent, assisted living facilities are an appealing option because they often offer a variety of activities and opportunities for seniors to interact with one another and to stay active. Assisted living facilities are generally paid for privately with a few exceptions, including long term care insurance or partial assistance from Medicaid.
Independent Living Communities
An independent living community is another viable option for senior living. These communities are for independent, active seniors who enjoy the idea of living in a community. Independent living communities are much like living in a condo or as a part of a community with an HOA. Often maintenance, housekeeping, and landscaping are part of what is included with living in these retirement communities. Many seniors choose this type of community when they are no longer able or no longer wish to maintain a home. The housing options for independent living communities range from detached homes to apartments. Another benefit of retirement communities is the wide range of amenities and activities available. Seniors are often lonely and living among other seniors can provide friendship and companionship. Residents in independent living communities pay privately, and the cost varies from one community to another.
Memory care facilities provide a more specialized senior living option for seniors who have serious cognitive impairments, such as Alzheimer’s or dementia. These facilities are much like assisted living facilities, but cater to cognitive impairments. They may even be a specialized part of an existing assisted living facility. The staff at memory care facilities have specialized training that helps them better assist residents with cognitive impairments. They are often planned intuitively to help patients who may become easily disoriented. These facilities also give extra consideration to security for residents who may wander due to their cognitive impairment. If a senior needs this kind of care, it is important to plan and look for facilities that provide it ahead of time.
Senior living options vary greatly in care and cost. It is important that seniors have conversations with their families about the needs they have or may have in the future, as well as the cost of the type of care they wish to have. The earlier the planning begins, the better off the senior and the family will be when the time comes to seek alternative living options. This planning should be a part of the overall legal and financial plan of the senior. If you have any questions, please contact us at 1.800.660.7564 or visit our website: www.covertlaw.com.
Creative Financial Approaches to Long Term Care Services
Creative Financial Approaches to Long Term Care Services
Long term care insurance was sold aggressively in the 1980s, 90s and thereafter to offset the costs of seniors needing to live in a nursing home, assisted living or needing at home health care. Now, however, the business of long term care insurance has dramatically changed. What was once over 100 insurers providing LTC policy for sale has shrunk to a pool of less than twenty insurers who continue to sell the health care product. The big financial problem was that the majority of insurers had badly underestimated the longevity of these long term care policy holders and how many claims would be filed during their lifetime. The model became unsustainable from a business perspective.
As reported by the Wall Street Journal (https://www.wsj.com/articles/millions-bought-insurance-to-cover-retirement-health-costs-now-they-face-an-awful-choice-1516206708) the industry is now in financial turmoil and has turned to the old adage of privatize the gains and socialize the losses; the translation being that millions of people age sixty-five or older with long term care policies are facing steep rate increases. It is not uncommon for a policy holder to face a fifty percent increase in their premium while some of the worst cases are upwards of ninety percent. Because the industry itself used such poor benchmarks and miscalculated projections, policy holders are seemingly left with two choices: Pay the money or leave your coverage after paying into it for years, and sometimes decades.
What if you want a different choice? Everyone would agree that being priced gouged for premiums as you age is inherently unconscionable but if the policy is discontinued what then will happen to the peace of mind long term care brings? What was once the safety net of senior aging care (without becoming a burden to family members) is rapidly disappearing.
CNBC has recently reported about this very issue and suggests getting financially creative for long term care. (https://www.cnbc.com/2018/02/27/heres-a-surprise-source-you-can-tap-for-long-term-care-services.html) There is a surprising source that you can tap in order to maintain protection for yourself but it requires planning, professional help and time. Do not delay.
The financially creative premise is to become asset poor, impoverished, and qualify for Medicaid which pays for nursing home care and services. This does not mean the legacy you built during your lifetime will not go to your selected inheritors. On the contrary the assets you own must move out of your name to qualify for Medicaid. The assets will then shift to your designated beneficiary since to qualify you as an individual cannot have over $2,000 in assets.
To begin you will need to retain the services of a qualified elder law attorney, who may also bring in an accountant and a financial advisor. Ideally, you will be able to wait five years before needing long term care and the help of Medicaid. If there are assets transferred during the “five year lookback” it may be subject to penalties or make the applicant ineligible for some period of time requiring them to pay out of pocket.
Now with time on your side it becomes critical to select the right vehicle for transfer. These can be annuities but more often tend to be irrevocable trusts. The assets in the irrevocable trust are no longer under the control of the older person and can provide protection from certain creditors. The vehicle chosen for transfer of assets is very important not only for the older individual but the recipient as well. In the case of an outright gift of appreciated assets (i.e. stocks or real property) there would be no stepped up cost basis which could lead to crushing capital gains taxes when it is time to sell. An elder law attorney with input from your accountant and financial planner can help you choose the right transfer of wealth plan.
Elder law attorneys are closely watching changes in Medicaid,, as Congress is often proposing legislation to change the program.. Be certain your elder law attorney is up to speed on the current requirements, as the eligibility requirements can change very quickly in each state, and sometimes each county.
Though you may never have thought you would find yourself creatively trying to qualify for Medicaid while protecting assets, the current long term care premium prices preclude a large portion of seniors from being able to pay the cost of the policy. Genworth Financial reports the national median cost of a private nursing home room to be $97,455 a year. It doesn’t take long to be wiped out at that cost without long term care. Medicaid may be your solution and time is of the essence for planning.
Contact our office today and schedule an appointment to discuss how we can help you with your planning.
Covert | Law
Covert | Law
Your Plan. Your Family. Their Future.
- - We Take Care of Families: Today - Tomorrow - Forever - -
NEIL R. COVERT, Attorney at Law
Clearwater - Sarasota - Fort Myers - Naples
© 2019 Neil R. Covert, P.A. - - All Rights Reserved.