How Technology Helps Seniors Stay Socially Engaged While Socially Distancing

Everything we have come to know about successful, healthy aging is contingent upon connection to those around us. The opportunities for people to laugh, move, and learn together is foundational to aging success. Enter the coronavirus pandemic to change all of that. Now aging Americans must stay socially engaged while maintaining a physical distance. This issue touches us all from senior wellness professionals, medical staff, families, inter-resident connections, and those aging in place at home and alone. The internet of things, and the virtual links it creates, is a great solution to implement in a socially distanced, troubling pandemic world.

Virtual technology tools were becoming more ubiquitous before the coronavirus. Yet, the need for emotional well-being as the especially vulnerable aging population of America became isolated was the accelerant solution to address the problem. Fitness classes ranging from tai chi to yoga and other forms of movement became available in droves of senior online classes. Connecting with family members or health professionals through telemedicine also became crucial as regular visitations and routine medical appointments became impossible.

Virtual tools provide a great advantage for social distancing as no meeting space is required. Senior interaction with tech tools has brought new learning and skills opportunities, providing a sense of connection, purpose, and pride. Older adults share their newfound prowess in video messages, multi online person chats, and more. Grandparents and grandchildren find common ground in a technological world, and grateful parents/adult children are happy for the means to address the social isolation problem and create stronger inter-generational family ties.

Beyond the connection of friends and family, technology brings email, instant messaging, social media sites, brain games, wellness bingo cards, music, even virtual cruises with daily ports of call to keep seniors connected in isolation. Many aging adults associate full-length feature films with a movie theater and do not realize they can watch nearly anything they want via streaming services, 24 hours a day, whenever they choose.

While the internet and these technology tools provide virtual interaction and entertainment, not every senior who needs it can afford a tablet computer or laptop. Many communities are holding campaigns to raise funds for those in need of these digital devices. Nursing homes can receive a stipend from the Centers for Medicare and Medicaid (CMS) through the Civil Monetary Penalty (CMP) fund. Funding through CMP provides communication aids such as tablet devices and webcams that enable virtual visits. However, each facility has a limit of $3,000 to ensure a balance in distributing CMP funds. Because these items may be shared among negative COVID-19 residents, it is critical to avoid entering highly personal information into device applications or programs. Shared tablets are not a good way to check bank accounts, shop online, or have your senior pay bills.

Be wary of too much learning too quickly for a senior. Don’t overwhelm the aging adult with the technology, rather focus on what it provides. Slowly introduce different aspects of the technology and be certain the senior has a firm understanding of how to repeat the process to get online or risk creating frustration. Also, educate them that even though they can Skype, Zoom, et al. with others does not mean their loved ones or friends will be available at all times for them. Set a schedule for meaningful connections, managing their expectations to keep them from cycles of disappointment. Share successes, experiences, even failures with residential staff, other family members, and residents. Find out what works the best overall. Keep the strategy simple for the best results. 

Be aware that seniors without strong social connections before covid-19 may feel incredibly left out. The technology connecting people doesn’t work if there is no one to communicate with on the other end of the virtual line. Residents without existing social networks typically rely on the now non-existent shared dining room and community events for interaction, and they may now be left behind. These residents need more assistance in learning how to join online classes and interactive communities that share like interests. Senior Americans unfamiliar with the internet of things do not understand the scope of what is available to them.

CMS Administrator Seema Verma states, “While we must remain steadfast in our fight to shield nursing home residents from this virus, it is becoming clear that prolonged isolation and separation from family is also taking a deadly toll on our aging loved ones.”  Help your loved one to leverage digital technology and the internet to stay connected during the coronavirus pandemic. There is still hope and human connection available, and vulnerable and isolated seniors are in desperate need of both.  If you’d like to discuss, simply give us a call at 1.800.660.7564 or email us at info@covertlaw.com.

Ten Tips to Help Seniors Reduce the Risk of Falling

The Centers for Disease Control and Prevention reports one out of five senior falls causes a serious injury like a broken bone or head trauma. Injuries of this sort can make life difficult for an older person to do everyday activities or live on their own. Half of the time, when a senior falls, it goes unreported to their doctor, and the person is likely to become fearful, cutting back on their activities. Not reporting a fall creates a vicious cycle. Fearfulness leads to less activity, making a senior weaker, which increases their chance of falling. Right At Home provides ten tips to reduce the risk of a senior falls. These tips are science-based, and seniors should try to implement them in their daily lives.

The first tip is to talk with your physician about your risk factors. You may have existing health conditions such as hearing and vision loss, arthritis, osteoporosis, or cognition problems, which raise the risk of falls. If you are honest with your doctor about your fall history, they can implement strategies to lower your risks. Every fall matters and should be addressed. Falling just once doubles the likelihood of falling again. Keeping quiet about a fall stops you from receiving personalized prevention advice.

You will need to get enough exercise of the right type. When visiting your doctor, ask for a customized exercise program. Activities will likely include endurance building, muscle strengthening, and increasing flexibility and improving balance. Even if gyms, recreation, and senior centers are closed due to COVID-19, you can work out at home with little need for equipment. There are also practical ways of improving your activity levels through gardening, house cleaning, and dancing about the house to some inspirational music. 

If you have balance problems, get specific help. The vestibular system of the inner ear is crucial to your sense of balance. When you have vestibular dysfunctions, the likelihood of you falling increases. Many vestibular problems are treatable, which will improve balance. Your doctor may also prescribe a virtual balance class that uses special activities and exercises like tai chi, which will enhance proprioception, which is your sense of position. Also, make sure your shoes are properly fitted. Incorrect shoe size, width, or shoe type affects balance and stability.

CDC

The American Academy of Orthopedic Surgeons recommends that you or a family member conduct a fall-prevention in-home inspection. The advent of the coronavirus pandemic keeps people in their homes more than ever, so it is time to identify any fall hazards. Remove clutter and improve the lighting throughout your home. If necessary, have grab bars installed in the bathroom or on entry stairs in the garage, or other key areas. Always keep clear pathways to walk throughout your home.

Routinely have your doctor review all of your medications. Although the prescription and over the counter drugs you take help you manage your health conditions, mixing them can produce dangerous side-effects. Dizziness, drowsiness, and confusion are all typical side effects of mixing medications. Bring a complete list of every medication and supplement you take to your doctor or your pharmacist. If you start a new drug, be wary of any side effects, and report them immediately to your doctor.

Make sure to have routine hearing and vision exams. Ears provide you with important information about the environment around you that helps to prevent falls. If you have hearing aids, use them, and have them calibrated often. The same holds for eyeglasses; keep your lens prescription up to date and wear them. If you wear bi or trifocals, or progressive lenses, inquire if a second, single-vision lens pair of glasses would make your walking safer.

Eat a diet rich in foods that help prevent falling. The proper nutrients promote bone and muscle strength. You will often need to up your intake of calcium, protein, and vitamin D. Maintain a healthy weight through a nutritious diet plan your doctor prescribes for you. Be honest about how much alcohol you drink. If you drink, limit your intake as too much alcohol substantially increases your risk of falling. The same holds true in states where medical and recreational marijuana are legal. Talk to your doctor about your intake habits.

If you use walking aids, do so properly. Mobility devices like canes, walkers, and more can help you maintain your stability and avoid falls if used correctly. How you position your hands and use mobility devices is crucial. If you are unsure about your device, have a physical therapist or other medical professionals recommend, properly fit, and train you in its safe use. If you think you would benefit from a walking aid, make an appointment with a reputable medical group to get one.

Avoid walking if you feel distracted. Whether you are in unfamiliar surroundings or in your own home, being distracted often leads to falls. If you think about something else while navigating stairs, it is extremely dangerous and can lead to slips and falls. In the digital world of today, your smartphone may be the main culprit of your walking distraction. Sit down to take a phone call or text. Do not walk around a store, home, street, or sidewalk engaging with your smartphone when you should focus solely on walking. No phone call or message is worth a fall. Get somewhere safe and then interact with your smartphone.

If you do not think you can properly equip and de-clutter your home, or exercise safely in it, add home care as part of your fall prevention strategy. Right At Home and other caregiver groups can enhance walking safety in your home, provide transportation or run errands for you, provide appropriate care for seniors with cognitive issues, and create an extra measure of protection for you in your daily life. Being a confident and active senior, getting the help you need can keep you from unwanted falls.

These safety tips to prevent falls are easy to implement. Every year three million older Americans seek treatment at a hospital after they have fallen. Tragically, more than 27 thousand of them will die because of their fall injuries. Thousands more will experience disabilities leading to a loss of independence. The effects of falling are often life-changing or life-threatening for seniors. Put into practice these and other safety measures to keep you on your feet.  If you have any questions about this or anything else, please feel free to call us at 1.800.660.7564 or email us at info@covertlaw.com.

Looking for the Silver Linings Amidst a Pandemic

Record unemployment rates related to COVID-19 business closures have hurt business owners and their workers, many of whom are 50 years and older. Though workers of all ages have felt the effects of unemployment or reduced working hours, older workers will fare worse upon re-entering the workforce. Research shows the recession of 2008 found that those adults age 62 or more were the least likely group to re-enter the workforce, and it is most likely as the employment situation stabilizes the same will hold in 2020. Ageism plays a role when employers have huge swaths of potential employees from which to choose. 

Many unemployed older workers feel the effects of income loss and wild financial market swings wreaking havoc on their retirement savings accounts, as well as the potential that Social Security benefits may be reduced in the near future. Happily, before the pandemic, a trend towards later retirement, transitional work, and “encore” careers became the norm. Out of either necessity or desire, aging Americans choose to be active in the workforce, and policies and practices are starting to catch up to age discrimination. AARP has more than 350 companies who have signed an Employer Pledge that sources experienced workers. These companies provide job opportunities and career fairs online that are age-diverse.

Sheltering in place during this pandemic has kept many older Americans from having pre-existing physical, social, and emotional needs met as healthcare systems and network services for seniors are minimizing service to large numbers to protect and serve the most vulnerable.  This disruption of services like regular check-ups and elective procedures leads to a lack of personal care, proper nutrition, and medical management for many. Telehealth can remotely connect a patient to a medical professional, and with wearable devices, important medical information can be assessed in real-time by a doctor. If the situation warrants, medical intervention will follow. In the case of nutrition, beyond take-out and meal delivery services, grocery stores are now providing home delivery systems for fresh food. These delivery services include Instacart, Walmart Grocery, Safeway Grocery Delivery, Kroger ClickList, Vitacost, Peapod, AmazonFresh, and more.

The effects of increased isolation are producing more anxiety and depression in aging Americans. Loneliness is linked to negative mental and physical health outcomes such as cardiovascular disease, hypertension, cognitive decline, obesity, and death. The good news is that we live in a digital age where the Internet of Things (IoT) can connect people virtually. There is a steady growth of tech-savvy seniors who are well-versed in the use of digital devices and apps that let them talk real-time to family and friends. Family and inter-generational connections are stronger than ever since this pandemic has encouraged everyone to stay in touch. Programs like Students4Seniors and ZoomerstoBoomers are examples of younger generations lending a helping hand to seniors. Digital social connection is combating the negative consequences of isolationism.

Before the coronavirus, only about one half of Americans have had conversations about their end of life situation with loved ones. Only 27 percent of those have the legal documentation reflecting their wishes. The need to address mortality is uncomfortable but unavoidable for older Americans during this pandemic as they are disproportionately dying from COVID-19. There are general and specific pandemic-related end-of-life planning resources online that can help a senior think through scenarios before meeting with their attorney. Most law groups and individual attorneys are now set up to teleconference or video conference to create advance directives and associated legal documents. Many states are permitting online signature for these documents during the pandemic.

For every negative consequence of the coronavirus pandemic, there are solutions that drive positive outcomes, especially in the case of seniors. Efforts that improve the services of private and non-profit agencies, advocacy groups and policymaking, healthcare and business models are accelerating to meet the needs of our most vulnerable population. Technology, creativity, and sensitivity to senior needs are making life a better experience during a difficult time not only for seniors but also for the families and providers meeting those needs that create a stronger, more interconnected America that values its elders.  If you have questions or concerns, please feel free to contact us at any time by calling us at 1.800.660.7564 or email us at info@covertlaw.com.

The Top Ten Myths About Risks for Alzheimer’s Disease

Polling shows that the number one worry for Americans as they age is memory loss, outpacing fears of insufficient monies, and loneliness. The most prevalent among all dementia is Alzheimer’s disease. According to the Alzheimer’s Association Facts and Figures Report, Alzheimer’s accounts for an estimated 60 to 80 percent of diagnosed dementia cases. Projections for increasing numbers of Alzheimer’s patients in the coming decades is cause for concern. However, in this digital age where disinformation is in abundance, Right At Home has identified ten persistent myths about Alzheimer’s that should be dispelled for clarity’s sake and because worry increases stress levels, which is bad for the brain.

Myth #1: If I live long enough, I will likely develop Alzheimer’s disease.

The fact is that developing dementia is not a natural function of aging. While there are more diagnosed cases than ever before, and risks increase as we age, it is not inevitable that age equals Alzheimer’s. A University of Michigan poll of people in their 50s and 60s found half the respondents expect to develop serious cognitive and memory loss as they age. The statistics show only twenty percent of older adults will experience dementia.

Myth #2: If I have a genetic predisposition for Alzheimer’s disease, I can do nothing to prevent getting it.

It is a fact that a higher risk for dementia does run in some families. However, research data presented at the July 2019 Alzheimer’s Association International Conference suggest that even those with a higher genetic propensity to develop Alzheimer’s can lower their risk by adopting lifestyle choices that address brain health.Actionable lifestyle choices decreased dementia risks by 32 percent. A study of identical triplets from the University of Toronto (December 2019) revealed while two contracted dementia, the third did not. While there are no guarantees, there are preventable strategies.

Myth #3: If I already have amyloid plaques and neurofibrillary tangles in my brain, I will soon experience Alzheimer’s disease.

Today’s medical technologies like PET scans and other brain imagining techniques show that some people have these plaques and tangles but display no obvious outward disease symptoms. The brain is highly resilient and plastic, creating workarounds or backup connections that bypass the affected brain cells. 

Myth #4: Specifically engineered brain games will provide the mental exercise I need to protect against dementia.

Neurologically focused computer games, puzzles, and similar brain “training” products are somewhat useful. Still, they do not provide a greater benefit than other mind-challenging activities. You are just as well off learning a new language, taking an art class, reading, playing video games, traveling, or even working at a mentally stimulating job. These activities help the brain build new connections; in particular, learning something new is especially beneficial.

Myth #5: All I need is solitary brain exercise.

The fact is that while engaging in intense mental focus is great, interacting with other people is more beneficial. Socialization stimulates many more regions of the brain, and those who regularly engage in social activity consistently have a lower incidence of dementia. Staying connected, even virtually in this age of social distancing, also prevents becoming part of the epidemic of loneliness, which leads to many negative health consequences. There are many reasons to stay socially engaged. 

Myth #6: Skipping physical exercise is permissible as long as I get mental exercise.

It is a fact that brain stimulation matters, but it is also a fact that exercising our muscles is as important for brain health because the two work together. Physical movement requires brain and muscle memory. Whether you move about a park or a gym, you need to know where to go. You also must know what to do, how to complete each task, and move to the next. In this multi-tasking body/brain exercise work, each function enhances the other—muscles matter.

Myth #7: Only aerobic exercise benefits the brain.

Muscle-strengthening activities are as important as aerobic exercise. It is true that having an aerobically fit heart is good for a healthy brain but lifting weights, doing squats, planks, pushups, and working with resistance bands are all known to boost memory. In some instances, strength training can even reverse memory loss because building muscle makes us overall healthier, and it also increases several beneficial chemicals in the brain.

Myth #8: I can take supplements to protect my brain health.

The fact is you are better off eating a diet that includes lots of quality vegetables and fruits, grains, poultry and fish, and healthy fats like olive oil. America is overrun with vitamins, herbs, and promises of brain health substances. The World Health Organization has recently stated no reputable study confirms the value of these vitamins, herbs, or supplements. Save your money and talk to your doctor about a healthy diet instead.

Myth #9: Drinking alcohol protects my brain.

The fact is experts do not agree about the studies associated with moderate drinking, in particular red wine, with brain health. However, the experts all do agree that drinking too much is very harmful to the brain. Heavy drinking shrinks the brain. The Lancet Public Health Journey states that “alcohol disorders are the most important preventable risk factors for all types of dementia.” As part of your diet plan, talk to your doctor about a safe amount of alcohol for you. 

Myth #10: Alzheimer’s disease is not related to other health conditions.

No disease is unrelated to other health conditions in our bodies. Many chronic conditions and diseases can harm our brains like high cholesterol, high blood pressure, diabetes, depression, stress, insomnia, hearing and vision loss, and even gum disease raise the risk of Alzheimer’s. Regular healthcare that manages existing conditions can also lower the risk of memory loss or slow its progression. Routine medical appointments, taking medications as prescribed, and following doctor recommendations can help to preserve brain health.

If you or a loved one have been diagnosed with Alzheimer’s, now is the time to plan. We can help create a comprehensive legal plan to address how to pay for care without losing everything you’ve saved over the years. We would be happy to talk to you about ways we can help.  Just give us a call at 1.800.660.7564 or email us at info@covertlaw.com.

Developing an Effective COVID-19 Vaccine for the Elderly is a Challenge

Older Americans, the most at risk of COVID-19, are the least likely demographic to respond well to a vaccine. A vaccine shot works by fooling the body into believing it has been infected with a virus, thereby prompting its immune system to fight the intruding pathogen by making antibodies. Unfortunately, as we age, antibody production weakens, part of the process known as immunosenescence. A compromised immune system makes older adults more susceptible to viral and bacterial infections. The Wall Street Journal reports that 90 percent of flu deaths in the US every year are people over the age of 65. 

What’s age got to do with it? The thymus, located center of your chest just below the neckline between the lungs, is a major source of pathogen fighting T-cells. Some of these specialized cells help the immune system make additional defenses against infection called antibodies. As we age, the thymus production of adaptable T-cells is depleted as the thymus fills with fatty tissue. The result is an old immune system that is ill-equipped to fight off new viruses. The Center for Disease Control and Prevention (CDC) posted a July 17 analysis of more than 50,000 COVID-19 deaths in the US, identifying that 80 percent were people age 65 or more.

An aging thymus also complicates the development of a COVID-19 vaccine. A vaccine’s design provides instructions to our immune system, which T-cells help to guide appropriately. However, the thymus has exhausted most of its reserve T-cells that adapt to recognize unknown pathogens by the age of 50; thus, the ability to “train” other immune cells to fight is lost. Many vaccines rely on the skill sets of fully functional T-cells.

Traditionally, the biopharmaceutical vaccine market has concentrated efforts on childhood vaccines. Martin Friede, a coordinator for vaccine and product and delivery research with the World Health Organization (WHO), states, “Up until very recently most of the focus of the vaccine community has been on saving lives of young children. The people who need the vaccine the most may actually be the people in whom the vaccine might not work.” Friede further comments that it isn’t solely about the thymus as individual vitality can translate into different vaccine responses. Some older people may be off to play a round of golf while others may be too frail to walk unaided.

Deputy director of clinical research for the Institute of Vaccine Safety at Johns Hopkins Bloomberg School of Public Health, Dr. Kawsar Talaat, echoes Friede’s sentiments, “We hadn’t been designing vaccines for the elderly for a long time.” Dr. Talaat is helping to facilitate coronavirus vaccine developers to test their shots in older adults. The Food and Drug Administration (FDA) is also working with drug and biotech companies easing restrictions for experimental vaccines to be tested earlier during clinical trials on older adults. 

The New York biopharmaceutical giant Pfizer is currently conducting tests for potential COVID-19 vaccines in older people. The company is studying whether increasing the vaccine dosage could better protect the elderly as higher doses in existing flu vaccines make them more effective in older populations. At Moderna Therapeutics, results from a phase-one trial of its novel mRNA vaccine are in; however, a second phase two trial is being conducted specifically for adults age 55 and older. Several phase three trials have also already begun.  Many biotech and pharmaceutical companies are eager to be the first to introduce a successful FDA approved COVID-19 vaccine. 

If the development of a COVID-19 vaccine specifically for the elderly remains elusive, scientists are hopeful that immunizing others around them can make a difference. Vaccinating children, health care workers, and potentially silent coronavirus carriers, could create enough herd immunity and would lower the risk of older people becoming infected. Sometimes it is possible to protect a vulnerable group by targeting other groups around them. Meanwhile, the work continues to find a workable COVID-19 vaccine for the most vulnerable Americans, the elderly.

We help seniors and their families deal with challenges around appropriate care and how to pay for it. If you would like to discuss your situation with us, please don’t hesitate to reach out.  Simply give us a call at 1.800.660.7564 or email us at info@covertlaw.com.

Living Alone in Your 50s and 60s Increases Your Risk of Dementia by 30 Percent

Living arrangements for aging Americans are decidedly leaning towards aging in place. Nearly all older adults prefer to age in the comfort of their long time homes and familiar community surroundings. Aging in place often means living alone. Pew Research findings show that older people are more likely to live alone in the United States than in any other country worldwide. This preference of living solo, however, comes with hidden danger. Research from Science Times reports that living alone in your fifties and sixties increases the likelihood of dementia by thirty percent.

The conclusion drawn is based on a report from sciencedirect.com, a website replete with large databases of scientific, academic, and medical research. Findings indicate that social isolation is a more important risk factor for dementia than previously identified. In this age of gray divorce (also grey divorce) and social distancing due to the coronavirus pandemic, adults living alone in their fifties, sixties and beyond, are at greater risk than ever for cognitive decline, leading to dementia.

The lead author of the study, Dr. Roopal Desai, says that overall increases in dementia cases worldwide can be due to loneliness, stress, and the lack of cognitive stimulation that living alone brings. Biologically, cognitive stimulation is necessary to maintain neural connections, which in turn healthily keep a brain functioning. Staying socially interactive is as important to cognitive health as staying physically and mentally active. 

Health care professionals in the U.S. are implementing a “social prescribing” strategy to improve the connection of a patient who lives alone to a prescribed range of services like community groups, personal training, art classes, counseling, and more. Unfortunately, in the days of COVID-19 social prescribing is limited to virtual connections between people. However, virtual social engagement is better than no social engagement at all.

Why can’t an adult, choosing to age alone, maintain their health with physical exercise, crossword puzzles, and other activities that stimulate their brains without the input of human socialization? It turns out that social isolation presents a greater risk for dementia than physical inactivity, diabetes, hypertension, and obesity. Brain stimulation is vastly different when a person engages in a conversation rather than in repetitive games and puzzles. Carrying on a conversation, whether in person or virtually, is far more stimulating and challenging to the brain’s regions.

Conversation with other people chemically evokes neurotransmitters and hormones, which translates into increased feelings of happiness and reduced stress through purpose, belonging, improved self-worth, and confidence. It turns out that being human is undeniably an experience at its most healthy when shared, and a mentally healthy person is prone to stay more cognitively capable.

Maintaining this human connection can be challenging, particularly if you are one of the many Americans who are opting to age in place – especially in this era of Covid-19. In the first place, aging is replete with reasons to reduce activity and become isolated when facing particular types of stressful events common to later life years. Role changes associated with spousal bereavement through death or divorce, household management, social planning, driving, and flexibility all fall prey to functional and cognitive limitations. Without the benefit of an involved family or social prescription, it is easy for an aging adult to spiral into social isolation, loneliness, and depression, all of which are causally linked to cognitive decline.

If you or your aging loved one actively chooses to live alone, it is imperative to maintain a vibrant social life. Staying cognitively healthy is associated to satisfying social engagement as well as physical activity. If you live alone, reducing the risk of developing dementia will allow you to continue living out your years as imagined, with independence and control, thanks to your continued human interactions.

If you have concerns about your current living arrangements (or those of a loved one who needs care), please reach out. We help families create comprehensive legal plans that cover care and financial concerns. We’d be honored to speak with you.  Simply give us a call at 1.800.660.7564 or email us at info@covertlaw.com.  Stay healthy.   Stay safe.

Finding a Continuing Care Retirement Community

Continuing care retirement communities (CCRC) are gaining in popularity across the United States. Sometimes referred to as life plan communities, the goal is to provide a long-term care option for older residents. These residents prefer to live in the same community, though in different phase locations, during their aging process. In essence, it is a continuum of care that will see you through your pre-planned stages of older life.

The selection process of this community type can be challenging as there are nearly 2,000 CCRCs throughout the country, and each offers different kinds of housing and levels of care, for a price. Most residents will begin CCRC living independently in an apartment or single-story home. As health situations present themselves, the resident will transition to assisted living and, ultimately, to a skilled nursing level. The phases of community living are among the most significant benefits of a CCRC as it provides familiarity and the stability of a wide range of activities, services, and care in one place.

The federal government provides an online public service through the US Administration on Aging known as Eldercare Locator that connects you to services for older adults and their families regarding CCRCs and much more. The service is also available via telephone at (800) 677-1116. LeadingAge is a member group association for non-profit eldercare that provides and maintains an aging services directory where you can plug in a zip code and search for local retirement communities. Caring.com and seniorliving.org also have referral search options to locate a nearby CCRC.

According to AARP, nearly two-thirds of CCRCs will charge an entry fee to join their community. The average initial payment ranges from $239,000 to over one million dollars in some communities. After an initial entry fee, residents will pay a monthly fee, typically running between two to four thousand dollars. Before putting money down, there are questions to ask. LeadingAge suggests these following questions:

• Is the CCRC for-profit or non-profit? What is the financial strength of the community?
• What does the monthly fee include?
• How do you specifically aid me in maintaining my independence and freedom?
• What types of emergency response systems are in place?
• Do you survey residents to measure levels of satisfaction? Can I see the most recent surveys?
• What type of input and feedback about the community do residents enjoy?
• How do you define independent versus assisted living, and at what point would I have to transition to assisted living?
• How is aging in place supported even if my needs change somewhat?
• Who selects community events and programs, and what are the five most popular?
• May I review your residency agreement?

If you locate a community you like, then it is time to ask more detailed questions. Is the CCRC nearby to a hospital? How far away are your medical doctors from the community? How convenient are amenities such as public transit, grocery stores, dry cleaners, and other services?

Check on the credentials of the staff at the CCRC. Is their interaction with you professional? Do they seem willing and eager to help? How available are the administrators of the community? Is their office open throughout the day to deal with issues that may arise?

What are the floor plans and options of available housing? Are residences equipped with dishwashers, washer and dryer, and microwaves? Are homes equipped with grip bars and nonslip floors? Are common areas and green spaces well maintained? Do the assisted living and nursing facilities offer private rooms with baths? What are the locations of emergency exits, sprinklers, and other security features that are in place?

Talk to the people currently living in the community and get their insights as to the value and livability of the CCRC. Ask about meals; in particular, are special diets accommodated? What are the personal services available such as housekeeping, laundry, and hair salons? Is there any transportation service?  What are the costs associated with these services? Check on recreation and social activities too. What events are regularly available? Are their clubs and common area for residents? What is the availability of an exercise facility and fitness classes? Are there opportunities for worship?

Regarding health care services, check what is available to you at each level of care. What is included in the entrance and monthly fees? Does the CCRC have specialized dementia care areas or other specific health condition areas? Is there a pharmacy on-site? Are all prescription drugs handled by qualified staff, and do they monitor the medication?

Once you have chosen a community, review the contract very carefully. A CCRC offers three basic contracts:

• Extensive life-care contract or Type A includes a full range of services but also carries the highest fee. This contract provides unlimited assisted living, medical treatment, and skilled nursing care with little or no additional costs. 
• Modified contract or Type B offers a defined but limited set of services. Any services beyond the ones in the contract will incur a higher monthly fee.
• Fee-for-service contract or Type C generally has a lower initial enrollment fee, but the residents must pay for the services they require, such as assisted living, skilled nursing, or memory care. 

Some CCRCs even offer a rental contract known as Type D and a Type E equity agreement where you purchase a share of your unit instead of an entry fee. No matter what contract type you select, all CCRC contracts are notoriously complex, so it is imperative to retain an attorney to review the specifics to protect your finances and future residency.

There is a lot to consider when joining a continuing care retirement community. Share your expectations and thoughts with family and loved ones and ask for their help. Do extensive research on several potential communities before finalizing your decision. Ask a lot of questions when you visit each community. Carefully review any CCRC contracts or agreements before you sign them. A CCRC can be an enjoyable living experience when you find the one that meets your criteria and needs.

If you have questions or need help reviewing a contract or agreement with any type of facility, we would be happy to help. We can also discuss a plan for how to pay for care on a long term basis and how to protect your savings from being depleted.  Just give us a call at 1.800.660.7564 or email us at info@covertlaw.com.

Technologies to Help Seniors Stay Emotionally Healthy During the Coronavirus Pandemic

In the best of circumstances, adults in senior living communities and long-term care facilities combat loneliness and some degree of isolation, which is linked to anxiety, depression, cardiovascular disease, and other ailments. During the COVID-19 pandemic, the Centers for Disease Control and Prevention (CDC) senior facility guidelines have increased problems of isolation for the more than one million American adults who live in assisted living facilities and nursing homes. These seniors and those in private homes who are sheltering-in-place are experiencing the absence of direct connection to family and friends. Today it is more important than ever to provide mechanisms for their health and happiness while practicing social distancing during the coronavirus quarantine.

For those in long-term care facilities, now that visitation has ceased, the only human contact is with the facility staff and doctors who present themselves wearing full personal protective equipment (PPE) such as masks, gowns, and gloves. The minimal contact is with staff that no longer looks familiar and may even appear scary to residents, particularly those with cognitive impairment. Social distancing practices and wearing masks in a loved one’s home have a similar effect and create frustration as cherished hugs are not permissible. The longer the threat of infection from COVID-19 goes on, the more likely that loneliness will become a mental health problem. Intelligent and creative use of technology can alleviate the stresses for many of these seniors by providing entertainment and communication.

Most seniors prefer structure and reliability, so coordinate daily check-in times with your loved one. It can be as simple as a phone call or text. For seniors who are comfortable with more advanced technology, Skype, Facetime, WhatsApp, WeChat, Loop, and Zoom all provide video content as well as voice. Don’t forget the option of a group text to include multiple family and friends at the same time, and if you are using Facetime or Zoom, you can create a “family dinner” experience. Even the cooking aspect of the meal can be integrated into the video chat.

Wellness devices that track exercise like Apple watch, Garmin, Kardia, or Fitbit are great prompters for seniors to keep moving and exercise. These devices can be set for modest 10-minute group exercises, which are important to keep blood flowing, stimulate brain function, improve the immune system, and reduce depression. Activity level notifications can be sent to your phone, providing the opportunity to nudge your loved one out of sedentary behavior. During quieter moments, a carefree companion pet like Hasbro’s Joy for All Companion Pet can bring fun, companionship, and comfort for your loved one. These may be robots, but they are soft and cuddly with realistic fur and respond to petting and hugging motions creating a give and take relationship. If your senior prefers a dog, Joyforall has a companion pet golden pup that can also bring comfort. These robotic pets offer a soothing and joyful experience that often prompts fond memories of a senior’s beloved pet.

Hapbee is available for pre-order and is an augmentative wearable device emulating normal molecular interactions in the body’s small, specific magnetic fields that can replicate different feelings. There are six general mood categories; alert, happy, pick me up, calm, relaxed, and sleepy through safe, low energy magnetic signals. Worn as either a headband or loosely around the neck, a senior can use Hapbee to guide their feelings to their desire. Another technology that can help during this pandemic is the HumanCharger light therapy device made by Valkee. This device is a powerful tool for those people over the age of 60 experiencing lack of sunshine, melatonin production, reduced energy levels, and difficulty getting restful sleep. The HumanCharger stimulates the photosensitive receptors in the brain using calibrated white light. This light passes through the ear canals and structure, and this stimulation affects the brain’s neural circuits via neurotransmitters like dopamine, serotonin, and noradrenaline. In just 12 minutes a day using the Valkee device and LED earbuds, a senior can experience the needed dosage of sunlight to re-establish the body’s natural circadian rhythms by resetting a person’s natural internal clock.

Finally, do not overlook the world of online gaming to keep a senior engaged during the COVID-19 pandemic. Word Cross, Candy Crush, Words with Friends, Cookie Jam, Minecraft, and more can provide hours of entertainment. If your senior is a retired pilot, try a flight simulator, or if they prefer chess, they can play against a computer or individuals worldwide. Your loved one can watch favorite TV shows, movies, or keep up with family and friends via Facebook. Video games and computer use, in general, promote hand-eye coordination, mind training, and memory, and raise endorphin levels that keep blood flowing. While your senior is engaging in the online world, however, be sure they do not fall prey to a self-destructive behavior known as “doomscrolling.” The onslaught of dystopian stories relating to the coronavirus pandemic combined with stay at home orders can find a senior binging on bad news, trapping them in cycles of negativity. So, in your daily check-in, ask where your senior is spending their time online to ensure they don’t spiral into a vicious cycle of negativity which creates anxiety and depression.

Encourage your senior loved one to employ technology to help reduce feelings of isolation and loneliness. Many seniors are unaware of just how varied and robust online entertainment and personal technology has become. All these technologies can help a senior maintain emotional balance and wellness during this pandemic and beyond.

If you would like to discuss how we help families deal with issues relating to long term care, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Alzheimer’s and Family Caregiving

This year, in 2020, a significant portion of the American baby boomer generation has reached the age of 65 or older, which increases their risk for Alzheimer’s and other forms of dementia diseases. By the year 2030, the 65 plus age segment of the population will increase substantially, accounting for over 20 percent of the American people. In the absence of a cure, the number of cases of Alzheimer’s disease will increase. Projections that these Americans will survive well into their eighties, nineties, and beyond will dramatically increase. These longer life expectancies are due to continuing medical advancements in conjunction with improved social and environmental conditions. 

The Alzheimer’s Association 2020 report entitled Alzheimer’s Facts and Figures cites that 83 percent of daily help for older Americans comes from family members, friends, or other unpaid caregivers. Of that 83 percent providing help, 48 percent (more than 16 million) do so for someone with Alzheimer’s disease or different dementia types. Annually, the number of hours these unpaid caregivers provide for their loved ones is estimated to be a staggering 18.6 billion hours of non-compensated care. These hours have an intrinsic value of 244 billion dollars to this nation, not a difficult number to arrive at considering the lifetime care costs in 2019 for older Americans who have dementia was 357,297 dollars. Fully 70 percent of the total dementia cost of care is borne by a family member who provides unpaid caregiving and out of pocket expenses that range from prescription medications to food for the loved one who has dementia.

Even these staggering estimates for lifetime care costs are probably significantly underestimated. Expenses do not take into account the impact of dementia on a family caregiver’s health. Nor does it account for a decrease in workplace productivity and lost wages due to decreased hours on the job when caregiving deems it necessary to skip work. Why is it these caregivers are so willing to provide assistance and care to a person who has Alzheimer’s or another form of dementia disease? The Alzheimer’s Fact and Figures report cite three main reasons for this sort of selfless devotion to a loved one.

The first is that for 65 percent of them, the caregiver has a strong emotional desire to keep the family member at home with them, especially in times like these with the Covid-19 pandemic. The second is that 48 percent prefer to maintain proximity and closeness to their family members, making oversight easier and safer. Finally, 38 percent of caregivers indicate an obligation they perceive to care for their loved one with dementia. Words like love, and a sense of duty, are often cited as motivating factors to assume the care responsibilities for a family member who has dementia. Only 8 percent of older adults with dementia do not receive help from a family member or other informal care provider. 

Who are these caregivers primarily? About two-thirds of them are women, and 30 percent of them are age 65 and older. Sixty percent of caregivers are married, cohabitating, or in a long-term relationship, and more than half of them are assisting their parent or an in-law with dementia. Approximately one quarter are in the sandwich generation, meaning they simultaneously tend to their aging parents and raise younger children.

Due to disease progression, nearly all Alzheimer’s and dementia sufferers end up in full-time nursing facilities. Loved ones are experiencing loss of judgment, orientation, and practical communication skills in the mid to late stages of Alzheimer’s disease. Some may exhibit strong personality and behavioral changes and become aggressive or even violent. At this moment, the family caregiver must accept they are limited in their ability to continue to provide substantive care and transition to more of an emotional support role as well as advocate for their loved one, interacting with the facility and staff to assure appropriate care. This transition is a relief to many family caregivers who often experience feelings of intense burden, impaired mood, depression, and poor health while caring for their loved one with Alzheimer’s in the home.

Unpaid caregivers experience a wide array of challenges when caring for their loved ones with Alzheimer’s or other forms of dementia disease. Financial, physical, social, and emotional well-being are continually shifting and often not for the caregiver’s better. While it is very generous and selfless to choose to care for a loved one experiencing dementia, it is also depleting, and most often, the “reward” for the service is saying a final goodbye to someone you love who no longer recognizes you. Caregivers of all types need to set boundaries to reduce stress for their own needs and reach out to local groups or forums online to share in successes and frustrations. Tending to your personal needs as an unpaid caregiver is especially crucial when caring for a loved one with Alzheimer’s or other dementia diseases.

We help families who have loved ones with dementia make sure there is a solid legal plan in place to cover care, how to pay for it, and how to prevent losing everything to the high cost of long term care. If you’d like to discuss your particular situation, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Health Care Power of Attorney: Specific or General

You have the right to decide what kind of medical treatment you want to receive from doctors and health-care providers. If you can speak up at the time, you can express your wishes yourself. But if you become incapable because you’re ill or injured, you need to plan in advance. Designate a person whom you trust to speak for you. You do this by creating what’s known as an “advance directive” or health care power of attorney.

You also have a choice about the kind of document you prefer. You can ask for a short document that simply conveys general authority on your agent to make health-care decisions for you – or you can opt for a longer document that details the specific powers you give to your agent.

For both versions, we offer a checklist to assist you in discussing your wishes with your agent beforehand.

The General Version

This version is short, clear, and easy to understand. It states, generally, that you have given your agent the authority to speak for you. Your agent knows your wishes, because you have discussed those wishes with him or her beforehand.

The Specific Version

This version goes into detail about what you would like your agent to do for you. For example, it includes the request that providers and your agent consult with you if possible. If not possible, it includes a list of procedures that you authorize your agent to decide on your behalf. Included are decisions about what kind of residential facility you want to be placed in, that an agent can visit you and bar others from visiting if appropriate, can advocate for pain relief, can consent to psychiatric treatment, can decide about anatomical gifts and organ donation, and the document provides procedural details about enforcement.

You will be covered with either version. The choice is yours.

Living Will

You may also want a separate Living Will for end-of-life decisions. This document becomes effective when you can no longer care for yourself, walk, talk, recognize loved ones, or are in the final stage of an incurable illness. At that point, you can decline expensive, high-intensity care that likely would not improve quality of life.

Choosing Your Agent

The person you choose to be your health-care agent must be someone you can depend on to have good communication skills, remain calm in difficult situations, and deal flexibly with complexity that might arise in reconciling your wishes with available medical options. Choose that person carefully.

Health Care Preferences Checklist

We can offer you a checklist, to help you discuss your wishes with your agent. This is not an easy conversation. It’s hard to contemplate a time when our health has declined or we suffer injury or accident. It is also challenging to try to imagine various scenarios involving situations that can be complicated by numerous medical contingencies.

Still, your agent needs to know what you would want in a variety of situations. These include whether to decline or accept life support and mechanical interventions, when you would opt for or decline surgery, and your preferences about blood transfusions, medication, and religious observance.

For certain states, the checklist also contains a signature line that proves you have discussed your wishes as to feeding and hydration tubes. Otherwise, if your agent doesn’t know what you would decide, the law in some states would take away from your agent the right to decide about those kinds of measures.

Don’t hide your documents!

When it comes time to use your documents but they 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. Make sure your documents are readily available. Give a copy of them to your agent and ask your doctors to include them in your medical records.

You will have done your best to see that your values and health-care choices will be honored.  Let us know if you have any questions concerning this or any other matter.  Simply call us at 1.800.660.7564 or email us at info@covertlaw.com.

Beneficiary Designations: Pitfalls You May Not Know About

You might think that leaving your property to your heirs would be simple enough. You make a will or a trust, you do a transfer-on-death deed for your real estate, you put your kids on your bank account, you designate beneficiaries for your life insurance and retirement accounts, and you’re done.

If only things were that simple. The result you wanted can be seriously foiled, if all the above elements are not carefully coordinated. 

After you consider the following, we hope you’ll agree that it’s best to consult a qualified attorney. That’s the person you need to help you construct an estate plan that will do what you want it to do.

A pitfall: Conflict between deeds and wills or trusts

If your will or trust conflicts with a deed for real property, the law will resolve the conflict for you by following the deed, not the will or trust. This can produce unintended results. 

Suppose Mary wanted to divide her property equally between her two children, John and Jane. She recorded a beneficiary deed for John so he could inherit the house. She wrote a will leaving money to her daughter Jane that was roughly the same value as the house.

Subsequently, however, Mary forgot about John’s deed. She made another will that split everything equally between John and Jane. 

On Mary’s death, John ended up getting significantly more than Jane. The portion of the second will including the house would be invalidated, because the earlier deed would supplant the will. So John got the house through the deed, plus half the money through the will. Jane got half the money only. That was not what Mary intended and the unfairness damaged John’s and Jane’s relationship.

A similar pitfall: Conflict between beneficiary designations and wills or trusts

Financial accounts can transfer automatically to people of your choice, avoiding probate, if you designate beneficiaries by means of “transfer on death” (TOD) through your broker. But you must not depend on your will to change TOD designations. The beneficiary designations establish a contract between the holder of the account and you. When you pass, the holder is legally obligated to transfer your account to the beneficiaries you designate, regardless what your will says. The designations, like deeds, supplant wills.

So if you have named your spouse as a beneficiary of, say, a retirement account, and then you get divorced and forget to change the beneficiary designation, your ex-spouse – and neither your new spouse nor your children nor anybody else – will receive the account proceeds when you die, regardless what your will says.

Underage beneficiaries and guardianship proceedings

Suppose your financial advisor calls to alert you that you have not designated beneficiaries on your accounts and that if you don’t do so, your estate will have to go through probate when you pass. By making TOD designations, your beneficiary would simply present a death certificate and the assets would transfer to him or her without the need to go to court. That sounds good. So you follow your advisor’s suggestion and designate your beneficiaries.

In the meantime, your lawyer drafts a good will for you. This will, as good wills should, contains a subtrust providing for underage beneficiaries. Your lawyer, echoing your financial advisor, explains that the subtrust is intended to avoid the necessity of court proceedings.

Your efforts to avoid court will be defeated, however, if you choose an underage beneficiary to receive your financial account through TOD. Guardianship proceedings would still be necessary to administer the money until the beneficiary came of age.

It would have been better to route the gift to the underage beneficiary through a will or trust and not through TOD designation. If wills or trusts are properly drafted, they contain provisions to administer the underage beneficiary’s inheritance privately and thereby avoid the court guardianship proceedings.

Another pitfall: Disabled beneficiaries and government benefits

The pitfall here is similar to the one above. If your beneficiary is disabled and gets a TOD (or any other kind of) inheritance, the inherited money could jeopardize the beneficiary’s entitlement to government benefits. Most benefits programs are “means-tested.” To be eligible, recipients must own practically nothing. If your beneficiary were suddenly to inherit, he or she would lose benefits and end up having to pay for care until the inheritance was spent. That could involve a lot of money!

Rather, like for underage beneficiaries, the disabled beneficiary’s inheritance should be routed through a will or “supplemental needs trust” (SNT) that imposes restrictions on spending. With those restrictions in place, the benefits would keep coming, and the inheritance assets could be used to pay for “extras” that benefits don’t cover. These extras might include payment of real estate taxes, upkeep of a residence, or vacations or a flat-screen television. The inherited money would be managed by a trusted person and the disabled beneficiary would still continue to receive the crucially important benefits.

Bank accounts and disabled or underage beneficiaries

The pitfall is the same as above. If you have designated underage or disabled beneficiaries by making your accounts “payable on death” (POD), court proceedings will be necessary in the case of the underage beneficiary, or the inheritance could jeopardize or eliminate the disabled beneficiary’s government benefits.

“Spendthrift” beneficiaries

The problem is likewise similar here. If your beneficiary has a gambling habit or drug addiction, or if he or she needs bankruptcy protection from creditors, and if he or she inherits without trust protections, the inheritance could be lost to the beneficiary’s detriment.

Joint tenancy of real property

It may be tempting to avoid probate by putting real estate in your beneficiaries’ names as joint tenants. But if multiple people own real estate jointly, all must agree on what is to be done with the land and all should contribute equally to property maintenance expenses. This can create disputes. A better solution might be to subject the property to probate, to dispose of it in orderly court proceedings. 

Joint bank accounts

The intent to avoid probate here is similar to joint tenancy of land, but putting your bank account in your and your children’s names exposes the funds to risk that should be avoided. Once a person is named as a co-owner of a bank account, that person has immediate and unfettered access to the funds. The funds are thus exposed to misappropriation by the joint-tenant child, or they can go instead to the child’s creditors in bankruptcy, or to ex-spouses in divorce proceedings.

It would be better to create a power of attorney that allows a trusted agent access to bank-account funds for your benefit while you are alive. Then, for when you pass, you could name beneficiaries via a POD designation with the bank – but remember the warnings above regarding underage or disabled or spendthrift beneficiaries. Those beneficiaries’ access  to funds should be protected by a trust.

A lot of moving parts

Each of the estate-planning strategies above could work well in and of themselves, but, taken together, may have an adverse impact. Crafting a plan that combines and coordinates the various strategies requires expertise and care. That care is worth taking, to safeguard the wealth you have built up over the years. Don’t risk a result you don’t want. Call on us to design a plan that harmonizes all the moving parts, so the gears will work together and you will leave the legacy you intended.  Simply give us a call at 1.800.660.7564 or email us at info@covertlaw.com.