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The Hardest Question: Who Draws the Line?

The Hardest Question: Who Draws the Line?

In this Covid-19 epidemic, a wrenching question especially demands an answer: if you or someone you love is taken down into life-threatening illness, how far would you want extreme life-prolonging measures to be tried?

For us who are particularly vulnerable – seniors, those with compromised immune systems, those already struggling with medical conditions – this question is particularly stark. Many people are familiar with DNR orders, “do not resuscitate.” These are intended for cardiac arrest. The threats posed by the current virus, though, more often implicate breathing problems. The longer time spent on a ventilator, the greater the chances of permanent damage, disability or death .

Many are dying alone, without their loved ones present. The New York Times recently reported on a particularly heartbreaking case

Most people over sixty with a serious illness say they would prefer to be kept in comfort at the end, even if that care shortens life. But where to draw the line? How much time alive would you be willing to sacrifice, to decline aggressive treatment and possibly die sooner? The need to provide at least some answers is important not just for you. Clinicians and caregivers need guidance, too. 

2017 study showed that approximately two-thirds of Americans had neglected to provide prior guidance by creating advance health-care directives like health care powers of attorney and living wills. Back then, most of us could not have imagined being in an epidemic like the one now.

Even if you or your loved ones have already done the responsible thing and created advance directives, now is the time to review those documents to make sure they reflect what you want under current conditions. 

Health-care providers are ethically obligated to do everything feasible to keep us alive. If we have no advance directives in place, the system will take over – and families can end up in long-lasting anguish for having had to be the ones to make the final call. Don’t let that happen. Think through the question for yourself and talk with a person whom you trust to make that decision for you if need be. Call us for your advance health-care directives – and may you and yours not need them for a good long while.  Simply give us a call at 1.800.660.7564 or email us at info@covertlaw.com. if you have any questions.

Telehealth Replaces Many In-Person Medical Appointments

Telehealth Replaces Many In-Person Medical Appointments

Through the use of videoconferencing over wireless devices and remote health tech monitoring, telehealth can connect patients to vital health care services. According to the American Hospital Association (AHA)fully 76 percent of US hospitals are using some form of telehealth for their patient groups. 

 

 

During this COVID-19 pandemic, the federal government has freed up some regulations that previously stifled telehealth practices by increasing Medicare coverage allowances as well as permitting doctors to practice over state lines, further increasing telehealth demand. This unprecedented surge in patients is stressing major telehealth providers’ technical infrastructure as well as the availability of physicians, physician assistants, and registered nurses who can deliver accredited virtual care. Huge backlogs are becoming the norm as telehealth ready hospitals and other facilities scramble to meet the demand.

Addressing the incoming demand is not that easy as major health systems like the Cleveland Clinic are experiencing a fifteen-fold increase in telehealth visits per week, and that number is likely to increase.  For those lacking standard internet connectivity, doctors are expanding phone consultations and recording videos as telehealth services increase asynchronous connection capability to address rural patients lacking reliable broadband capability for health services during this pandemic. The Cleveland Clinic also has a health bot (an automated online interactive chat window) COVID-19 risk assessment available on its home page where you can follow the prompts to determine your risk level for coronavirus based on your given answers. The University of Pennsylvania (Penn Medicine) is receiving virtual health care requests faster than clinicians can respond to them even though the hospital’s daily consultations have gone from 6 to 60 online appointments. Hospitals across the country are experiencing a similar explosion in the number of telehealth requests.

Many Americans do not seem to be fully satisfied with gathering their information about COVID-19 on websites such as the Centers for Disease Control and Prevention and the World Health Organization. Instead, they are opting for more personalized contact via a telehealth provider, which may be decreasing fear levels more than providing additional insights as medical personnel uses the guidelines established by these reliable health organizations.

The telehealth service sector is hoping that the coronavirus pandemic demonstrates the value of remote health services resulting in an enduring shift to its delivery mechanism in the future. Even when stretched beyond full capacity, telehealth allows the pooling of health care resources and delivery of them to where they are most needed. Though not currently operating to its full potential, telehealth during the time of the coronavirus pandemic remains one of the safest ways to receive medical attention and advice. 

We encourage you to reach out to your medical provider to determine whether telehealth is an option should you need medical attention. It is a much safer way to talk to a health care specialist and determine what type of treatment you may need.

We are also available for online meetings during the COVID-19 pandemic. If you would like to set up a meeting, simply visit our website for information on how we can connect, or call us at 1.800.660.7564 and email us at info@covertlaw.com.

Americans of All Ages are Creating Their Wills During COVID 19 Pandemic

Americans of All Ages are Creating Their Wills During COVID 19 Pandemic

There has been an explosion in the numbers of Americans rushing to make their will online. Understandably, the coronavirus pandemic has created the scramble to set up wills and end-of-life-directives. However, online do it yourself (DIY) wills are often deemed invalid as they do not comply with all of the legal requirements of your state. According to Caring.com, the prevalence of will and estate planning has been on the decline since 2017 but this trend is quickly reversing itself with the advent of the coronavirus pandemic.  


So, who needs a will? Ask yourself if you care who gets your property or money if you die? If you have minor children, do you care who will act as their legal guardian? The answer is anyone married, anyone with children or anyone with assets needs a properly executed will. Wills are governed by state law. Your will should reflect your wishes in the language and format required by the state in which you live for it to be valid. 

Many law offices are turning to teleconference with their clients to address social distancing protocols while still providing legal services such as writing a will. Businesses like Zoom are experiencing a quadrupling of daily users. Part of this significant increase includes hosting secure attorney/client meetings for will preparations. The importance of an attorney guiding you through the process of creating a will cannot be understated as they understand the nuances of how things need to be written. Once your will is complete, it must be correctly notarized as mistakes made in the will-signing process can potentially invalidate your will. Your attorney will guide you through the signing process, and could involve signing during a video conference. 

Beyond the creation of a will, many Americans are increasingly concerned about their powers of attorneys, health care surrogates, living wills, and end of life directives. These “life documents,” as they are active while you are alive, are equally as important as your will. Named executors, successors, beneficiaries, power of attorneys should have several back-up representatives as the mortality rate due to the coronavirus remains unknown.

According to research in a recent New York Times report, health care workers are more likely to contract COVID 19 than the average person. During this pandemic, many doctors and other medical professionals are rushing to have their wills drawn up. In addition to doctors, anyone on the front lines in the fight against COVID 19, from hospital custodians to nurses to EMS responders, should either make a will or review and possibly update their existing one. However, the truth is no matter what your profession or likelihood of contracting this virus, you should have a properly executed will during this time of considerable uncertainty.

There are few things you can act on during the COVID 19 pandemic that can bring you assurance and a sense of relief. The legal creation of your will or living trust and life-directives (Designation of Health Care Surrogate, Living Will, HIPAA Authorization, Medical Emergency Card for your wallet) are actions you can take that protects you and your family. We can help. Call us at 1.800.660.7564 or email us at info@covertlaw.com to schedule a phone or video conference and we’ll get this importance process started for you.

Senior Living Workforce Issues During the Coronavirus Pandemic

Senior Living Workforce Issues During the Coronavirus Pandemic

Fears that provisions in a coronavirus-related relief action by the US government could have severely curtailed the workforce in senior assisted living, independent living, memory care, and continuing care retirement communities provide a cautionary tale. The bill, HR 6201, is a multi-billion dollar aid package known as Families First Coronavirus Response Act. The bill has recently been signed into law by the US President. Influential leaders, CEOs, and corporate Presidents in the senior care and housing industry addressed facility workforce concerns directly to the House Speaker Pelosi (D-CA) and Senate Majority Leader McConnell (R-KY) before the passing of H.R.6201.

The Families First Coronavirus Response Law expands unemployment and Medicaid benefits, provides for free coronavirus testing, and mandates paid sick leave and childcare. Now that schools have closed throughout the country for an indefinite time, the fear is that many senior care workers will, unsurprisingly, put their family before their healthcare worker employment. A reprieve of sorts was added before the law being enacted, which states that only certain employees can qualify for paid sick leave.  Because of these loopholes, healthcare workers like first responders, and hospital and nursing home staff are ineligible for paid sick leave per the Families First Coronavirus Response Law (FFCRL) amid fears of staffing shortages among medical providers.

Healthcare worker exemption from some FFCRL benefits is a relief to the senior housing industry but by no means mitigates other workforce challenges during the coronavirus pandemic. The pervasiveness of this contagion means that healthcare workers will be exposed to, and some will fall ill with full-blown coronavirus symptoms and illness. Obviously, in these cases, the healthcare worker will be removed from the senior living facility for quarantine and recovery and to protect the facility’s residents and staff. One coronavirus confirmed healthcare worker begins a domino effect within a facility. Regular operations become short-staffed, and operators face the Centers for Disease Control and Prevention (CDC) protocols that co-workers must also face quarantine.

Beyond coronavirus exposure, symptoms, and the diagnosed virus itself, there is the problem of how healthcare workers respond in a pandemic. The non-stop news and social media coverage of the coronavirus has put many Americans on edge, including health care workers. In a crisis, some people respond logically and calmly, while others may become fearful of their own circumstances and respond emotionally. Most healthcare workers would put their own family’s health needs and care before any employment, and in a free society, there is nothing to compel them to stay in a job if they choose to tend first to their own family.

If your loved one is in a senior living facility, what can you do to mitigate the negative consequences of workforce disruption due to the coronavirus? In the short term, if you are able and your senior is well enough, you can put them under your care. Beyond family care, unless you have the resources for private pay at any cost, you, like the rest of us, are in the system and have to wait out the virus and its effects. There is no guarantee moving forward how the coronavirus will play out in senior living communities, America, and around the world. 

One of the few things you do have control over is to assure your loved one has proper legal documents for end of life decisions. Take the time to review them to ensure they are in order. A do not resuscitate order (DNR), durable medical power of attorney, and end of life wishes should be on file with your loved ones living facility and the local hospital. Additional legal copies of these documents should remain in your car or on your person in the event a facility is unable to locate the paperwork. Preparing for the worst-case scenario is a harsh reality; however, it could make the difference between chaotic suffering and a peaceful passing.

We’re here to help with appropriate documents for you and your loved ones – or just to answer any questions you may have.  We’re all in this together. Give us a call at 1.800.660.7564 or email us at info@covertlaw.com.

Stay healthy.

Questions to Ask Before Hiring In-Home Health Care Services

Questions to Ask Before Hiring In-Home Health Care Services

There is a wide range of home health care services available from daily household tasks to medical care. Before identifying a health care service for information, get a clear idea of what you are in the market for, be it recovery from surgery or long-term care for a chronic illness. The first step is to determine what you need help with and how often you need that help. Then assess your budget to provide home health care services. Get the specific information together about the types of insurance you will be relying on for payment. Determine what your loved one’s comfort level is with the process. A non-compliant recipient of care is going to make for misery all around. Have open and non-threatening discussions with your loved one and listen to their concerns. They may give you refined information about what type of individual to look for in a home health aide such as a non-smoker, early riser, card player, fastidiously neat person, an aide with experience with a specific chronic disease, or a multi-lingual aide.

Once you have identified your needs, though they may change or need to be scaled back, the search for a provider begins. The Mayo Clinic recommends finding a qualified home care service agency. Only deal with properly licensed agencies. Most states require agencies to be licensed and regularly reviewed, so check with your state health department. Be sure the agency is Medicare-certified for federal health and safety requirements. If it is not, inquire as to why. Ask about employee screening and if the agency is willing to provide references and follow up on them. Request a list of the doctors, hospital discharge planners, and other medical and administrative workers who have experience with the agency.

The individual home health aide should have proper credentials. Check to see that they are appropriately licensed by directly checking with the licensing body itself. Does the aide have a track record, and can they provide references from at least two employers? Follow up on any references given. Also, check with your loved one’s medical team to see if they have specific individuals who would be qualified and a good fit as your home health aide. Check for the quality characteristics of the agency. How do they monitor and train caregivers? Are caregivers licensed, accredited, and insured through the agency and proper licensing bodies? Is continuing education provided to health aides? Does the overall attitude of your potential home health aide have a positive attitude and display patience? Can scheduled hours be consistent with the patient’s needs? Will the same aide reliably and routinely show up?

Once you have a few qualified home health care options available, it is time to identify which agencies are affordable to your budget in the area of your loved one. It makes no sense to learn about specific services that you cannot afford, so pricing is one of the first considerations beyond qualifications. Ask the agency how it handles billing and expenses and get literature that explains services and fees. What levels of care do they provide? It is important to get detailed, written information as to all of the costs associated with home care services. If it is not in writing, be wary and walk away.  

Does the agency allow for fees to be covered by health insurance or Medicare? Talk with the agency’s billing personnel to ensure that your health insurance is accepted and be sure to understand the criteria that Medicare requires. Do not forget to ask about financial assistance or payment plans and again request that all the information is in writing. Once you understand the payment set-up, reconfirm what services are included in those fees. Often the sales pitch in the front office does not map out to the details of fee-for-service in the accounting department.

How much will the aide charge for providing home health services, and what services are included? Does this information mirror the data provided by the agency? Inquire about sick days and check for any scheduled vacations that might impact continuing service to your loved one. Who is responsible for payroll, social security, and other taxes associated with the aide? Does your aide receive standard holidays off as defined by federal guidelines; are they paid holidays, and who pays?

Before an aide enters into your loved one’s home, there should be a written care plan that includes details about medical equipment, specific care needs, and the responsibilities of the aide and the agency. This plan is usually in the form of a 3-ring binder where an aide denotes hours of care provided and can reference doctor input, which should be frequently updated. Also in the book should be a list of responsibilities and rights for everyone involved, which is often referred to as the patient’s bill of rights. This document varies widely, but Medicare.gov provides a detailed example of what they include. 

Inquire if the agency will continue to work directly with you and other family members after the aide is identified and hired for service. What is the process for elevating concerns and complaints? If there are problems, what is the protocol to resolve them? What are the emergency plans in the event of power failure or a natural disaster that can create safety hazards, particularly with medical equipment? What are the response times during a medical emergency? Is your aide instructed to dial 911 first? Check for a back-up plan in the event the home health aide has an emergency come up or has car trouble, or inclement weather precludes them from showing up.

According to Homecare.com, the average agency health care worker has between 1 to 2 years of experience, so implement the 3 R’s and get resumes, references, and reviews. Ensure the credentialing process through your identified agency includes home health aide social security number and trace verification. Be sure it checks federal and state criminal records, sex offender registry, and valid driver’s license check through the licensing department in your state. The aide’s license and credential verification need to be vetted. Finally, there should be contact with the Fraud and Abuse Control Information Systems (FACIS), which checks for wrong actions by individuals and agencies in the health care field.

To hire the best home health care services possible for your loved one do your research thoroughly before moving forward. Once you are engaging agencies and individual aides ask questions, get literature, take notes and then follow up on references, license verifications and credentialing. The research and care you put into the process upfront can stave off unwanted complaints or problems with your home health aide selection. You will create the best outcome for the patient by identifying the most qualified and affordable candidate for your situation.

We help families create comprehensive estate plans for anyone who may need long term care. We discuss care needs, how care will be paid for, who will make decisions, and much more. Give us a call at 1.800.660.7564 or email us at info@covertlaw.com – we’d be happy to help your family plan for the future.

Telehealth and mHealth Technology is Revolutionizing At-Home Medical Care

Telehealth and mHealth Technology is Revolutionizing At-Home Medical Care

The silver tsunami of Americans aging into 65 or more years puts additional strain on an already overtaxed US health care system which is running low on doctors, nurses, and caregivers. The surge in baby boomer seniors and near-seniors has put a focus on Telehealth and mHealth technology platforms which provide solutions that improve senior care monitoring, coordination, and management while aging in place. Telehealth is the distribution of health-related services and information by way of electronic information and telecommunication technologies while mHealth is its mobile counterpart. Both platforms allow long-distance patient/clinician contact and care, advice, reminders, education, intervention, monitoring, and remote admissions. The benefits of these technologies are particularly significant for seniors living in rural areas where medical facilities can be far from home. 

According to two statistics reported by AARP, there will be an increase of about 7 percent of the senior population who by 2050 will require additional caregiving and support due to chronic disease. The study also cites, “The number of people 65 and older in the United States is expected to increase to 55 million in 2020; to some 70 million by 2030, and 88.5 million, or 20 percent of the population by 2050. (Put yet another way, between 2006 and 2030, the U.S. population of adults aged 65+ will nearly double from 37 million to 71.5 million people.)” These statistics highlight the need for medical home-based technology because aging in place has become a ‘movement’ and is the best hope to meet the increasing senior demographic in the United States.

These medical technology platforms require reliable and robust internet connectivity which are readily available in urban and suburban areas but can be a challenge to provide in rural locations. It is possible to meet the need of internet availability in much the same way that the US created the Rural Electrification Act (REA) of 1936. The REA US-backed federal loans provided for installation and electric distribution systems to serve isolated rural areas. Today, the funding mechanism for remote internet service provisions can be similarly funded and not require a point to point wiring but rather wireless cellular towers. Additionally, assessing the amount of federal money paid out for 911 calls for seniors who wind up in the hospital after a fall could provide savings that could be redirected to a rural internet provisional act. Statistics show that over three months the average medical cost incurred by each accidental senior fall is about $35,000. The National Council on Aging (NCOA) reports that falls account for more than 2.8 million injuries treated in emergency departments annually and the number of hospitalizations is over 800,000. Multiplying $35,000 by 800,000 hospitalizations is $28 billion annually. Even a portion of that dollar amount would go a long way to helping rural seniors get reliable, affordable internet access.

Telehealth and mHealth platforms are integral to the success of aging Americans. All of the technology tools like laptops, remote control devices, and voice-activated personal assistants are also reliant on reliable internet connectivity. The integration of all of these tools to provide a quick link to a senior’s care team, whether that is their primary care physician, home health aide, wearable medical devices, family member or the neighbor next door is essential in the prevention of hospitalizations. The money that can potentially be saved has prompted the Centers for Medicare and Medicaid Services (CMS) and the American Medical Association (AMA) to expand reimbursement policy for remote patient monitoring programs through new Current Procedural Technology (CPT) codes. 

These remote monitoring medical platforms are readily available to put in place and become mainstream solutions to the aging US demographic. For those seniors who can age in place, these technologies are invaluable. The same monitoring tools can also reduce strain on doctors, nurses, and care staff at retirement communities, senior living facilities, long term care centers, and skilled nursing facilities. Mobile carts, video communication links, and connected devices at a facility can connect remotely with a doctor or specialist reducing the need for emergency medical services (EMS) or transport to a hospital. 

Telehealth and mHealth technology can create a medical care platform for seniors that enable them to live safely and comfortably at home. We help seniors and their families create comprehensive plans that cover long term care needs, how to pay for care, and how to choose appropriate people to help seniors make important decisions. We would welcome the opportunity to help you and your loved ones.  Just give us a call at 1.800.660.7564 or email us at info@covertlaw.com.

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 info@covertlaw.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 info@covertlaw.com.

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 info@covertlaw.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 info@covertlaw.com. 

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” 

https://theconversationproject.org/

and download the starter kit. 

http://theconversationproject.org/wp-content/uploads/2015/09/TCP_StarterKit_Final.pdf

 

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 

https://endoflifewa.org/

or End of Life Choices New York.

https://endoflifechoicesny.org/

 

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 info@covertlaw.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 info@covertlaw.com.

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 info@covertlaw.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 info@covertlaw.com.

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

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

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.

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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

1.800.660.7564

email: info@covertlaw.com

© 2019 Neil R. Covert, P.A. - - All Rights Reserved.

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