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The physical challenges of aging in place

The Physical Challenges of Aging in Place

According to AARP aging in place is a goal for 3 out of 4 Americans aged 50 or more. These seniors and near seniors are willing to employ alternative solutions to facilitate this. The alternatives include home sharing (32%), building an additional or accessory dwelling unit (31%) and locating into villages that provide services which enable aging in place (56%). These communities become a source of support and engagement for residents and give a sense of grounding through memories of a long time home environment.

Seniors who want to reside in a community (aka, age in place) rather than seek residential institutions or nursing homes are mostly dependent on unpaid caregivers and family members for assistance with activities of daily living (ADL). These activities include laundry, self-care actions like bathing and dressing, meal preparation, and transportation. Medicare provides some long-term care services and supports (LTSS); however, the LTSS program falls far short of the need. While the aging population in America is rapidly increasing, lawmakers are slow to respond to the insufficient funding to increase the availability of LTSS for seniors choosing to age in place. The goal of LTSS is not to replace but to supplement the contribution of unpaid family and caregivers. The addition of a Medicare benefit to support family caregivers as they help their loved ones would enable more aging adults to successfully remain in their homes. 

Technology has provided some solutions for caregivers, allowing caregivers to monitor their loved one remotely while they stay engaged at work. Smart environmental controls and personal assistants have lightened the load of constant oversight but cannot replace the helping human touch. Nearly 60 percent of seniors who have seriously compromised mobility report being house or apartment bound, while 25 percent of those seniors say they often remain in bed and do not dress daily. 

Low tech devices like canes, walkers, ramps, grab bars, shower seats and raised toilets to increase the level of accessibility and safety for aging in place seniors, however, transferring in and out of bed and moving around their homes still provides notable difficulty for many. The senior who wants to age in place is typically independent-minded and therefore have trouble foreseeing a time when help is not a want but a need. Aging adults and their families need to plan to address changing physical capacities before an adverse health event such as an unintended fall or dementia challenges change everything. While aging in place is a great goal for many seniors it requires planning just as if they were planning on moving into an assisted living facility. 

Johns Hopkins researchers report 42 percent of older adults who have problems performing ADLs or are living with probable dementia receive no assistance at all from family, friends or paid caregivers. That is a staggering number of unaided seniors. Additionally, twenty-one percent of seniors with a minimum of three chronic conditions and high needs received no assistance at all. LTSS through Medicare will have to make changes to meet the ever-increasing demand for human caregiving.

Approximately 60 percent of at home seniors use at least one low tech device, most commonly for bathing, toileting or in-home movement, throughout their day but their needs multiple as they age. Unfortunately, Medicare does not cover the expenses of most of these nonmedical devices and services. The resulting problem is seniors near, or at the bottom of the income ladder go without assistance, human or device, putting their daily lives in a very precarious position. Hardships for these seniors on the razor’s edge include the inability to pay medical bills or prescription costs, utilities or rent, and some resort to skipping meals to balance out their unaided lifestyle. At best this is heartbreaking, at worst it is inhumane.

The CHRONIC Care Act will allow Medicare Advantage plans to offer supplemental benefits for seniors to cover devices such as wheelchair ramps, grab bars, personal care, and transportation to chronically ill seniors however there are 21 million people who have needs to be met and how this will be paid for is unclear. Meanwhile, the 39 million people enrolled in traditional Medicare are entirely left out of any supplemental benefit. Affordability for at home care is a significant issue on a personal, family, and government level.

Caregivers and assistive low tech devices are an absolute necessity for seniors opting to age in place. The extent of the adjustments senior adults make as their needs become more profound are not well documented. As aging in place is a common strategy now, new solutions and programs must be explored to ensure successful aging.

If your strategy is to age in place, have a discussion early on with trusted counsel and family members to address some of the challenges you will eventually have to overcome. If we can assist you, please don’t hesitate to reach out by calling us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

The Looming Baby Boomer Retirement Crisis

The Looming Baby Boomer Retirement Crisis

A study conducted by The Blackstone Group, an independent research firm, on behalf of Bankers Life Center for a Secure Retirement outlines some very unsettling data regarding middle-income baby boomer retirement care preparedness. According to the survey above, the bleak financial reality of this demographic is that 79 percent of middle-income baby boomers have NO savings put aside to cover their retirement care. Couple this disaster savings scenario with the US government’s admission that for the first time since 1982 Social Security trust funds are being used to pay current benefits to recipients and Medicare’s reserves are being used to cover the costs of that program as well. It is the perfect storm of a looming retirement insolvency crisis.

Middle-income baby boomers for this study are defined as aged 53 to 72 with an annual income of $30,000 to $100,000 and less than one million dollars in investable assets. For those baby boomers in this demographic, a mere 4 percent of them have more than $100,000 saved for health care retirement planning, long term care, and general retirement preparedness. While 65 percent of these survey respondents prefer to receive retirement care in their current homes only 55 percent of them expected to be able to do so, and there is a disconnect at what age these care services will be required. A full 45 percent thought that assisted living circumstances would be needed between the ages of 71 and 80 while 37 percent said it would be between the ages of 81 and 90. The problem with these hopes is the ever-increasing presence of Alzheimer’s and other forms of dementia which can push retirees younger than ever into the need for assisted living and retirement care.

According to the survey, 40 percent of those surveyed consider retirement care planning to be a low priority or not one at all, 42 percent thought it to be a medium priority and only 18 percent identified retirement care planning as a high or very high priority. Incredibly 56 percent expected that Medicare would pay for retirement care as needed, including long-term care needs which Medicare does not cover. The costs of long-term care policies are cited as the biggest reason for not making the prudent insurance purchase. 

Dangerous misperceptions about how much retirement care costs and how to pay for it exist. It may seem incredible, but the truth is that baby boomers are better prepared to die than to live. Among middle-income baby boomers, 81 percent have formally made at least one preparation for when they pass away, usually in the form of a will or trust, while only 32 percent have a plan as to how they will receive retirement health care should it become necessary. 

The message is unmistakable; middle-income baby boomers need to address their underfunded retirement plans pronto. There is an overconfidence in this demographic that allows them to think they will be able to manage their and their spouse’s healthcare costs as they continue to age. The reality is that many of them are one bear stock market or health care crisis away from disaster. The federal government and its programs are just as unlikely to be able to stave off the financial crisis brought about by this willful ignorance of the costs of aging successfully. 

If you are in these incomes and age brackets, it is time to take a realistic look at what you can do to better prepare yourself for the coming years ahead. Being financially unprepared to age brings stress and family discord at a time when you should be living your best life. Be proactive, 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.

Autism in America

Autism in America

World Autism Awareness Day falls on April 2nd each year and is part of the larger World Autism Month observance. The observance includes hundreds of thousands of landmarks, homes, and buildings worldwide being swathed in light blue to recognize people living with autism. Many educational activities and events will take place to foster understanding and promote acceptance of autism spectrum disorder, or ASD, and of course, fundraising will intensify to endow growing research challenges to meet the needs of this highly individualized disorder.

The prevalence of autism is on the rise in the US. Because the condition first manifests itself before the age of 3, the majority of people receiving new diagnoses are under the age of 6. Autism spectrum disorder (ASD) refers to a broad range of behavioral conditions that include challenges with social skills, speech, and nonverbal communication as well as repetitive behaviors. The Centers for Disease Control and Prevention (CDC) now estimate that autism affects 1 in 59 children in the United States. That number has been steadily increasing in the past decade. 

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Autism is a very plural condition as there are many subtypes, primarily influenced by the environmental and genetic factors and has varying degrees of severity. Individuals coping with autism have distinct sets of strengths and challenges. That is why people are characterized as being on an autism spectrum because the individual scale of learning, thinking and problem-solving skills can range from highly skilled to severely challenged. Some who are diagnosed with autism spectrum disorder (ASD) may be able to live entirely independently while others may require some to significant support in their daily lives. 

Federal and state programs help assist families with children and young adults who have ASD. The Individuals with Disabilities Education Act (IDEA) federal law outlines rights and regulations for US students who require special education. The US Department of Education website outlines the basics of IDEA in simple terms. Are these services available until the young adult reaches the age of 22 and then what? There is a vast continuum of diagnosed and undiagnosed adults who are struggling to make sense of life while living with ASD.

Autism Speaks is an organization that calls on legislators and public health agencies like the National Institute of Health to promote research and advancements in understanding the increased prevalence of and complex medical needs that often accompany a person with autism. There has recently been a call to double the budget to advance research and create policies that better provide individual support and services as autistic children transition to adulthood and need employment and residential options. 

For people afflicted, autism is a lifelong condition and there is an unacceptable gap in our awareness of their needs particularly as children age out of federal school programs at 22 and are left to struggle with areas of basic life skills such as employment, housing, and social inclusion. Children with autism eventually become adults with autism. While some autistic adults become very successful, even famous for their success in arts and sciences (Albert Einstein, Dan Aykroyd, and others) others languish in their inability to navigate a complex world.

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www.quora.com/Is-there-a-good-visual-map-or-chart-showing-the-ASD-spectrum

Wherever an adult finds themselves in the autism spectrum, there are specific basic needs which mirror those adults without the challenge of ASD, and they are friendship, support, and opportunity. The mechanisms and interpretation of communication may differ but the human need is the same. Reliance on tax-funded programs is not always the best way to approach the needs to sustain them as funding and programs come and go. The real solution to meet the needs of adults with autism is essentially the same as the needs of children with autism. People in their families and communities must help their autistic loved one to make sense of and live in a complex world. The collective belief that they have abilities and strengths are can help reduce their anxieties. Accommodating support in ASD sufferer’s efforts to meet challenges and their own special needs can go a long way in assisting them to live more independent and successful lives.  

Are federal and state programs available? Are there community outreach programs that help young adults transition to independent living past the age of 22? Adults with autism differ from one another just as it is for children on the spectrum. 

If you have questions or would like to discuss your particular situation, please don’t hesitate to reach out to us at 1.800.660.7564 or by emailing us at info@covertlaw.com. 

The Changing Landscape of Memory Care

The Changing Landscape of Memory Care

 Projected demographics indicate that memory care is about to become a booming market of opportunity for facilities and their construction that tend to developing specialized memory care needs. While some facilities are stand-alone solutions for memory care patients, others will offer care that is already integrated into existing facilities that cover more than just the memory care sector. Lisa McCracken, senior vice president of senior living research and development at Ziegler says “With the projected increases in individuals who have cognitive impairments, and the decreasing number of caregivers, we do not expect that this pattern will go away anytime soon.”

 Some of the fundamental changes include inventive care settings that are vastly different than existing dementia support floors and secure units. Some of the care settings have not yet been realized as research and understanding of cognitive impairment continues forward. The fact is there will be a broader array of options to choose from in the near future. The “small house” model is becoming increasingly popular. The small house model is an intimate setting within existing nursing communities consisting of 10 enclosed, secure units and is designed for couples facing memory challenges. A small scale affordable housing model partially funded by the Department of Housing and Urban Development (HUD) is typically available to low-income seniors.

 Those seniors who can afford private pay for their memory care are being aided by assisted living facilities that design dementia care units like a neighborhood from an earlier time in the patient’s life. Often, dementia patients readily recall memories from long ago and these centers, designed to look like a community, are replete with porches, rocking chairs, carpet that mimics grass, and a fiber optic ceiling that allows transitional lighting creating a sense of the day and night sky. Other elements like aromatherapy can aide in calming residents or stimulating appetite depending on the selection of oils integrated into the therapy. All of these elements help reduce anger, anxiety, and depression which are hallmarks of seniors who suffer from dementia illnesses.

 

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https://www.facebook.com/lanternofmadison/

 

Full continuum care is improving as it meets the increasing numbers of its resident base with memory care issues. Many facilities are tapping into the expertise of geriatric psychiatry“  … also known as geropsychiatry, psychogeriatrics or psychiatry of old age is a subspecialty of psychiatry dealing with the study, prevention, and treatment of mental disorders in humans with old age.”  This field of study can enhance a memory care facility and improve the problems of anger, depression, and anxiety with medical components that address dementia. The techniques include a person-centered approach focusing on fostering autonomy, developing empathy with residents and even focusing on humor to help alleviate stress and increase the quality of life.  

 Professional caregivers will receive specialization in treating resident with dementia. Formal memory care education will become a more commonplace accreditation as the numbers of patients in need continue to increase. Rather than a certified nursing assistant (CNA) dementia patients will be tended to more frequently by certified dementia care nursing assistants (CDNAs). This change in credentialing will be driven by rising consumer expectation as well as tighter regulations that govern memory care. 

 Dementia illness is more prevalent than ever before, and so is the understanding that the disease has a long preclinical phase. Intervention and healthy lifestyle modification can continue to delay the onset of dementia in its clinical phase. Physical activity, social engagement, and brain fitness through smart devices and computer applications are wonderful cognitive compensation strategies that protect executive brain function, particularly in the preclinical phase of the disease. Beyond the known technology that already aides in the staving off of dementia, new cutting edge work can also help seniors compensate for memory loss allowing them to remain at home longer as well as enable senior facility operators to refine their services.

 Wearable cameras that have artificial intelligence (AI) facial recognition capabilities can provide a patient with the name of the person who is approaching them. AI can also help a senior’s cognitive load; helping them stay informed regarding day to day decisions. Newly developed website interfaces are making it easier for memory care patients to use and video, audio and sensor technologies can help detect depression or alert, through predictive analytics, a patient having a bad day or an increased risk of falling due to a change in gait. The potential for technology applications in memory care is seemingly endless and there is more research and development in the works. 

 Do you or your loved one have a plan in place in the event you become a memory care patient? Are you aware of the changing options available for living arrangements? Contact our office today and schedule an appointment to discuss how we can help you with your planning.  Simply email us at info@covertlaw.com. or call us at 1.800.660.7564.

Seniors Continue Embracing Technology

Seniors Continue Embracing Technology

Technology is providing seniors with a multitude of applications to improve their health, lifestyle, safety, and entertainment. While the younger generations may think these older Americans are the equivalent of technology dinosaurs, the truth is mid-life, and older Americans are becoming more digitally connected than ever before. The largest tech participating group of these seniors is generally more affluent and has higher degrees of education than their counterparts. Seniors with more limited incomes and lower levels of educational attainment are the most notably absent group in the digital divide between younger and older technology users. 

Smartphone ownership and its associated application (app) usage, social media, and online gaming continue to increase at a rapid pace with a full 91 percent of technology users 50 or more saying they use personal technology devices to stay in touch with family and friends. Texting by seniors (86%) has become as pervasive as email (87%). Smartphones are also a handy tool for planning optimal routes to and from locations as well as receiving up to the minute traffic information. Simply put, older Americans now leverage smartphone use in much the same ways that its younger counterparts do and in some ways, seniors (aged 60 – 69) are leading the charge in smartphone use to manage their medical care. Online banking and money management are becoming more prevalent with senior users as they become educated about and employ privacy mechanisms to protect their identity and assets in an online and cloud storage world. 

Online learning is prevalent in the senior demographic. An AARP survey shows 23 percent of older adults embrace online learning by taking classes for certificates, obtaining degrees, and how to Do It Yourself (DIY) tutorials. This percent of seniors in online learning is likely to continue its increase as mental agility and longevity become increasingly important due to the alarming rise of dementia disease in the aging population. While there is no direct evidence linking online learning to the staving off of dementia, it cannot hurt a senior to continue with lifelong learning as it may provide a sense of control and well being during their good years. 

The use of virtual reality in VE, virtual environment, is also on the rise for seniors. The growth rate is currently about 4 percent a year with 13 percent of adults aged 50 or more engaging in the technology. Nearly 90 percent of all virtual reality headsets are smart and mobile phone based. The ease of porting a smartphone into a headset which operates as the screen makes virtual reality a compelling tool for aging seniors. While it provides immersive realities for gaming entertainment, it also can give extensive exploration opportunities for those seniors with limited mobility. Imagine a senior who cannot walk being able to experience a tour of the ancient Greek site the Acropolis, enjoying a virtual scuba dive in the Great Barrier Reef, or taking part in a guided tour through a faraway museum without ever leaving their home, wheel chair, or bed. The mental stimulation and joy it can bring are just beginning to be tapped for the senior market. Virtual reality (VR) is projected to impact the gaming industry more profoundly than any other industry, and gamers include the senior market in a balanced way comparative to different age groups.

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https://www.statista.com/statistics/189582/age-of-us-video-game-players-since-2010

Wearable technology is gaining popularity among the senior market. They include products like smart watches, smart jewelry, fitness trackers, even smart clothing. While being worn, they provide intelligent assistance that can augment memory, intellect, communication, creativity, and physical abilities and senses. They also come replete with challenges such as interface interferences, power requirements, network resources, and privacy concerns. Wearable fitness trackers are becoming commonplace in assisted living, and nursing facilities as the technology will alert medical staff when a patient’s vitals are outside of their norm even if that worker is engaged in other tasks. 

Worldwide, corporations are very interested in wearable technologies, particularly as it relates to medical issues. Some seniors who would not qualify for implant surgery because of pre-existing health conditions might be able to use a wearable pacemaker rather than having a surgical implant procedure. Other techniques for nonsurgical intervention include smart patches and electronic tattoos that can regulate dysfunctional systems in the body. For those seniors who can tolerate implant surgeries, new and innovative ideas for micro device implants are bringing forward the concept of the trans-human. Trans-human is defined as a standard biological human being who is augmented by implants that might provide improved intelligence, awareness, strength, or durability. Even in the absence of a serious health issue, implants may soon be able to enhance the medical monitoring of seniors in their daily lives. Think of it as a highly accurate fitness tracker implant. These implants in “trans-humans” may be able to observe developing physiological and psychological trends and predict adequate responses to health changes in aging adults. 

Finally, the video game industry is one of the fastest growing sectors in the US economy. Annual sales in the gaming vertical of “techenomics” have reached $23 billion and are projected to continue to increase. While some of the games seniors are playing online are in the hopes of keeping memory and brain function in good working order, 38 percent of adults aged 50 or more are video gamers purely for entertainment purposes. While these games may provide entertainment and human connection (in situ or online), they also may share cognitive, and brain benefits as well as the senior adapts to ever-changing game scenarios, updated versions and expansions of online games. 

It is projected that seniors will continue to increase their exposure to and use of technologies at many levels. Development to meet the demands of senior needs coupled with their purchasing power will drive the technology industry for decades to come in ways that are not even imagined yet. For now, aging Americans are embracing technology and the benefits it brings to their lives.  As always, if you have any questions or concerns, please feel free to contact us at 1.800.660.7564 or by emailing us at info@covertlaw.com. 

US Justice Department Elder Fraud Sweep

US Justice Department Elder Fraud Sweep

In the largest ever nationwide elder fraud sweep the US Department of Justice (DOJ) has identified more than 260 defendants in fraud accounting for more than 750 million dollars. In each case, the defendants allegedly engaged in financial tactics that either specifically targeted or mostly affected seniors. The fraud operations are evident in every federal district in the United States. 

Fake drug discount cards, remote access to computers under the guise of technical support, relative in distress needing cash stories (the so-called “grandparents scheme”), insurance fees to collect nonexistent sweepstakes prizes, mass mailings and money mule fraud, and posing as debt collectors are some of the more prevalent schemes used by con artists. In one of the most horrific cases an 83-year-old woman was defrauded of her life savings by her caregiver; with no means to afford her retirement home bills, the woman sadly took her own life.

In earlier decades fraud schemes were not uncommon. Snail mail and phone scams however reached more limited victims. Now that digital technology, the internet, email, and social media is pervasive, transnational criminal organizations are “all in” to defraud the elderly of their money at a time when the cost to a senior’s life is frequently “catastrophic and irreversible” according to Attorney General William P. Barr. The Justice Department has vowed to prosecute these despicable crimes with an all-out attack against these swindlers and it’s a good thing as the numbers of incidence continue to rise. The current sweep involves 13 percent more criminal defendants, twice the amount of fraud victims and 28 percent more in elder monetary losses. In total, over 2 million older adults were affected by the current alleged fraud crimes. 

The transnational component of elderly fraud cannot be understated. The Office of International Affairs through the DOJ is working with numerous countries to secure evidence and capture defendants. Extraditions from Canada, The Cayman Islands, Costa Rica, Jamaica, and Poland are all part of this latest sweep of elderly fraud cases. Law enforcement partnerships such as the International Mass-Marketing Fraud Working Group (IMMFWG) is a network of criminal and civil law enforcement agencies including Belgium, Canada, Europol, the Netherlands, Norway, Spain, the United Kingdom, and the United States. By sharing information and providing avenues for criminal extradition this international body is a model of cooperation against specific threats that endanger the financial well being of member country’s residents.

What can you do at home to help protect yourself or a loved one from financial scams? Education is critical as to how these fraud operations function. A scammer will try to evoke a strong emotional response in their targeted senior to persuade them to part with their money. For example, a senior experiencing a high arousal emotion like excitement or anger makes them more susceptible to opt in on a risky decision. So a senior should not make what is called a “first flush” decision. Allow 24 hours to pass before opting in on an enticing scheme if you are becoming overly excited and feel pressure to make a quick decision shut down your contact with the person or organization and wait. 

One of the easiest ways to avoid scams is never giving out personal information to unknown entities. Ask for credentials, speak to supervisors, do a background check, get another trusted individual in your life involved in what you are considering BEFORE making any decisions. Have systems in place for a trusted family member or financial professional to approve of financial transactions when they are outside the scope of your normal daily purchases or bill payments. Also, review any auto deductions in your bank account monthly. Scammers often start with a small withdrawal to see if there is oversight in the account that targets fraud or identity theft.

Consumers can file elder fraud complaints with the Federal Trade Commission at www.ftccomplaintassistant.gov or 877-FTC-HELP. The Department of Justice provides resources relating to elder fraud victimization through its Office of Victims of Crime. Get educated; learn more ways to protect yourself by connecting with trusted counsel. 

If you have questions or would like to discuss anything you’ve read, please don’t hesitate to contact us at 1.800.660.7564 or by emailing us at info@covertlaw.com.

Memory Care and the Epidemic of Alzheimer’s

Memory Care and the Epidemic of Alzheimer’s

Alzheimer’s is a chronic neurodegenerative disease typically with a long pre-clinical phase which gradually worsens. Initial symptoms are often mistaken for normal aging and include problems with language, mood swings, disorientation, loss of motivation, poor self-care and behavioral issues. There are no treatments to stop or reverse the disease progression. Alzheimer’s accounts for 60 to 70 percent of dementia cases and is one of the most financially costly diseases. Usually, the disease onset occurs in seniors over the age of 65, and the average life expectancy is 3 to 9 years though the speed of the disease’s progression can vary. 

Estimates are that more than 14 million Americans will be diagnosed with Alzheimer’s disease by the year 2050 and the financial cost to the United States will total more than 1.1 trillion dollars. Memory and medical care for those who have Alzheimer’s will also create challenges for their families starting with the most basic of questions about memory care, understanding what it is, and what it entails. 

Currently, memory care for seniors with advanced Alzheimer’s is best provided in state-licensed assisted living residences or nursing homes with a secure unit designed specifically for memory patients. The unit may be a floor or separate building with security and other cueing devices to help prevent a patient from wandering. Memory care facilities offer programs that are designed to keep executive brain function active and engaged and also offer cognitive behavioral therapies designed specifically for those with memory challenges. However, these facilities are expensive, and with the Alzheimer’s survival rate of 3 to 9 years post diagnosis, many families are not able to pay the associated costs of memory care.

Because of these costs, many families become unpaid caregivers to their loved ones. In the earlier stages of the disease progression it is a workable situation, but before long this selfless act and huge undertaking can take a toll on the caregiver leading to inadequate care for the patient. It is during this family caregiver stage that exploring the longer term options for memory care becomes critical as there will come a time professional memory care will become necessary. There are several options to consider regarding paying for memory care which on average costs nearly 5 times more than seniors who do not require memory care.  

Is your loved one a US Veteran? Research about the Aid & Attendance benefits available to them. Not a veteran? Then explore options for long term care health insurance. Another option is to learn how to spend down assets to qualify for Medicaid. However this must be done very carefully and with the understanding that even with Medicaid there are, and will continue to be, long waiting lists to get into memory care facilities. If you are fortunate enough to be able to private pay for memory care, it is still important to investigate options to identify the right facility for your loved one.

How will you know when professional memory care is needed? Some of the more common indicators are when someone who has Alzheimer’s forgets to take their medication or forgets the codes to alarms or neglects to lock doors. When a person living with dementia forgets their basic house chores or forgets to eat meals, shower, change clothes or groom themselves that is a sign that memory care may be in order. Finally, psychological changes occur such as consistent feelings of anger or confusion, withdrawal or depression, even personality changes such as mistrusting others are indicators that professional memory care is needed.

All people living with dementia should make plans with their family and attorney in the early stages of disease progression as to how they want to be handled medically in the advanced stages of Alzheimer’s. It is much better to have this discussion very early on as it can provide a sense of relief to the patient knowing things will proceed as documented. 

In the absence of a cure for Alzheimer’s all seniors should proactively plan with their family and a trusted elder law attorney to create a plan in the event memory care becomes necessary. 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.

Simple Tips for Saving Money While Aging Well

Simple Tips for Saving Money While Aging Well

Your senior years should not be plagued with money woes. The stress that money problems bring not only ruins your aging experience but can also be disastrous to your health. Rising health care costs and your increased need for health care can add up to big bills that can further tax your health. To age well, you must use sound financial judgment as well as make healthy choices for your body and mind. The goal is to remain as healthy as you can for as long as you can and have a healthy bank account to support those goals. Beyond the obvious, such as choosing the right insurance plan and saving money for retirement, there are other strategies you can implement to further a successful and happy retirement.

Chronic stress is known to worsen health problems and can also accelerate the aging process. Though everyone experiences and handles stress differently, it is important to identify the specific stresses in your life and hone in on its source to be able to address it adequately. Relationship stress, family stress, and work stress can be treated through meditation and gentle yoga. The more you practice, the more significant the mental and physical benefits you experience. 

In the case of financial stress, meditation will not save you. You need a concrete plan to approach your problem. Develop a budget that will address which debts you need to pay off first and stick to the program. Learn to avoid excessive spending that puts you in a debt cycle. Once you are as debt free as reasonably possible, learn ways to increase your savings.

An easy way to lower your expenditures and increase your savings is to view the world as your gym. Thirty minutes of brisk walking five days a week in your neighborhood is excellent for your body and your mind. Bring your cell phone, but only use it in the event of an emergency. Take in the outdoors around you and let your mind be free. You can be active doing leg extensions or squats in your own home. You can do several ballet plies while cooking a meal and toe raises while brushing your teeth. Before you get out of bed in the morning move your pillow out of the way and stretch out your spine; arms overhead and extending through your toes. The idea is to connect your daily routine activities to a specific exercise and do it every time you enter into that everyday behavior. If you have physical limitations, talk to your doctor before implementing at home exercises or neighborhood walks.

Learn to limit the portions of food you eat. We are a nation of overeaters. In many countries around the world, it is unheard of to have a “to go” box from a lunch or dinner that is too big for consumption in one sitting. The Dietary Guidelines for Americans 2015-2020 recommend active men over 65 need 2,600 calories daily, while sedentary men require just 2,000; for women it’s 2,000 if active, and 1,600 daily calories if sedentary. Pass on the heaping helping and pass on a second helping. By limiting the amount of food you eat, you can maintain a more healthy weight, which in turn can improve your health and longevity, as well as save money. 

If you have room in your yard, start a vegetable garden, plant some fruit trees, and involve your friends to share in the workload and the resulting produce. If you don’t have a yard, join a community garden. Growing your food is an excellent way to increase the number of fruits and vegetables you eat and has the added benefits of making you physically active and socially engaged. By making a garden a group effort, you can prevent isolation which for many older adults is a risk factor for everything from depression to hypertension. If you have problems kneeling or being down on the ground, try using raised garden beds or even try gutter gardening. Gutter gardens are a simple way to grow vegetables that have minimal roots in gutters that are affixed to an outside wall at a height that is comfortable for you. Gutter gardens also remove the problem of bugs in the soil. A fruit and vegetable garden will lower your grocery bill and shift your eating habits to a more healthful plant-based diet.  Learn how to can or freeze your produce if you have a short growing season where you live. 

Make a small investment to solve a significant problem. A grab bar in the shower or lowering the height of your bed can help you prevent a range of serious injuries from a fall. Fractures and head traumas often result in a rapid health decline and even death. Improve your balance with gentle tai chi exercises. Be sure you have adequate lighting in your home. Fix uneven floorboards and get rid of throw rugs. By being mindful of how you move through your home you can avoid an unnecessary fall which will save you money by avoiding medical treatment and might even save your life.

Kick bad habits and start with smoking. Just because you have not already developed lung cancer after decades of smoking does not mean you won’t, nor will it help prevent other lung problems like emphysema or chronic obstructive pulmonary disease (COPD). Replace a bad habit with a good one as proposed above. If you drink alcohol on a daily basis or sometimes to excess, consider cutting back or quitting altogether. Alcohol contributes to unsteadiness on your feet and can precipitate you to fall. Do not take more than the prescribed dosage of painkillers or anti-anxiety medications and never mix them with alcohol. It is easy to become addicted to these drugs as you age because often they are used in the treatment of chronic conditions. You can build a tolerance to them and need progressively stronger doses. Try to find alternative ways to address your pain or anxiety. Cut back on sugar and fatty foods. 

If your day is not structured, create a schedule. Try to eat at regular times as well as have a predictable bedtime and wake up call. Your body will appreciate the regularity of life. Kicking bad habits to the curb can help you enjoy your retirement years with greater energy and health as well as save you a lot of money on bad habits that are expensive. Don’t tax your wallet and your well being.

There are many techniques for aging well and preserving your bank account. Some methods are simple while others require guidance by trusted counsel. Reduce the financial stresses of your retirement and contact our office today and schedule an appointment at our Clearwater, Lakewood Ranch, Fort Myers or Naples offices to discuss how we can help you with your planning by calling us at 1.800.660.7564 or emailing 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. 

How to Avoid Medicare Scams

How to Avoid Medicare Scams

By far the largest types of insurance fraud are scams against government and private health care insurers. Scammers frequently target government insurance like Medicare by stealing newly issued medical ID cards and then stealing identities. The Coalition Against Insurance Fraud estimates that tens of billions of dollars are lost annually to these types of fraud. Additionally, medical identity theft is now a top complaint received by the Federal Trade Commission. Billing fraud is also responsible for huge losses to Medicare funds and is difficult to assess as it can be a billing error or intentional fraud. 

How does this affect a senior on an individual level? Scammers typically pose as Medicare officials and ask people to pay for their new cards which in reality are free. Or they phone a potential victim with false news of a refund and ask for the person’s ID number and bank account number to deposit the refund. “Right now … everyone is being inundated with TV commercials, brochures and other official-looking documents in the mail about all the Medicare Advantage plans. It’s so confusing, and in an environment like that, fraud is rampant,” says Micki Nozaki of the California Senior Medicare Patrol. There are more than 50 million Medicare beneficiaries who can annually opt to swap Medicare Advantage and Part D prescription drug plans which provide scammers with the opportunity to prey on vast numbers of seniors.

The Centers for Medicare and Medicaid Services have a list of tips to help prevent fraud. The first and foremost is to protect your Medicare and Social Security numbers vigilantly. It suggests treating your Medicare card like you would a credit card and do not provide the number to anyone other than your doctor, or people you know should have it. Become educated about Medicare with regards to your rights and what a provider can and cannot bill to Medicare. Review your doctor bills carefully, looking for services billed for but not provided to you. Remember that nothing is free with regards to medical care; never accept offers of money or gifts of free services. Be suspicious of your provider if they tell you they know how to “bill Medicare” to pay for a procedure or a service that is not typically covered. Before leaving your pharmacy check to be sure your medication is correct, including the full amount prescribed and whether or not you received a generic or brand name medicine. If your prescription is in error report the problem to the pharmacist before leaving. 

Remember Medicare will never visit, call, or email you and ask for personal information such as your Medicare number, Social Security Number, address, or bank account number. Medicare already has this information and does not need you to provide it. Even when Medicare issues new cards that no longer contain your social security number in April of 2019 you will not be required to do anything. You can assume that anyone who claims to be helping you with Medicare and asks for your personal or financial information is a scam artist so close the door, hang up the phone, or delete the email.

When it is time to compare plans be sure to meet with a trustworthy advisor. Some insurance representatives give the industry a bad name by selling you a policy or plan that does not suit your needs or your budget. Some agents go so far as to ask you to sign a release form allowing them to make decisions on your behalf. Never sign anything related to Medicare without first reading it carefully. Additionally, it is a good practice to have a family member or lawyer review the document before signing it. The non-profit National Council on Aging (NCOA) has a free, brief assessment that allows you to compare plans online. You can also contact your local State Health Insurance Assistance Program (SHIP). SHIPs is a provider of free, federally-funded Medicare counseling via a trained volunteer or staff member. 

Medicare fraud wastes billions of taxpayer dollars annually. Carefully review your medical bills and have inaccuracies corrected. Guard your personal information vigilantly and be wary of people asking you to provide that information. Meet with a trusted insurance advisor or compare medical plan options using the sites listed above. If you are unsure about something call Medicare directly for clarification. 

If you have questions or would like to discuss anything you’ve read, please don’t hesitate to contact 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.

Balancing Caregiving and Your Career

Balancing Caregiving and Your Career

Providing care for a senior family member, particularly long-term care, can bring about lost wages and missed opportunities for the caregiver. A report by Genworth entitled Beyond Dollars 2018 shows that although statistically having to miss work to provide care is down 7% from 2015, overall 70% of caregivers still report missing work because of caregiving responsibilities. While the percentage remains high, employers are better able and more likely to meet the needs of an employee who also routinely provides family caregiving services. The corporate shift to create flexibility and policy that addresses caregiver needs in the workplace will continue to increase as the baby boomer population ages. The change is welcome as, on average, caregivers spend 21 hours every week providing care. 

impact of caregiving.png

Genworth:  Beyond Dollars Report

 

Flexible work hour policies are having a positive effect as caregiver employees can transport their loved one to a daytime doctor appointment or other scheduled event. Some of the employee’s workload is being shifted to online work remotely from their home while other employers will allow a coworker to donate vacation or sick time to a caregiving employee.Julie Westermann of Genworth toldMcKnight’s Senior Living“Access to caregiver support or employee resource groups is another benefit. Also, counseling, coaching or wellness programs specific to supporting caregivers themselves and the financial and legal implications.” There are additional policies and benefits available for family caregiver support that include subsidized in-home back up care and emergency care, and other low-cost or free resources and services.

It is widely projected that 70% of all seniors will need long-term care during their lifetime. Increasingly that care is being provided in the home by family, and the ages of both parties involved are becoming younger. Genworth found that the average age of a care recipient in 2018 is 66. Comparatively in 2010 62% were older than 75. The age of caregivers has shifted from an average age of 53 in 2010 to an average age of 47 in 2018. Fully 58% of family caregivers are now in the 25 – 54 year age bracket.

As the need for senior caregiving increases, employers will have to continue increasing accommodations to employees who are also family caregivers. For career planning purposes a family caregiver should take full advantage of coaching and support programs that outline future financial and legal implications of caregiving as it relates to their employment. Mitigating negative circumstances before they present themselves is the goal. The sooner a realistic assessment of needs for the senior is handled the sooner a caregiver can put a plan in place to protect their livelihood and future retirement.

Employers understand the negative impact that absences, reduced hours and chronic tardiness have on productivity and the bottom line. A caregiver must strategize how best to cover the responsibilities that could put their career in jeopardy. Corporate policy changes and additional resources regarding employees who are also caregivers are helping make this situation mutually agreeable. The percentage of caregivers reporting negative impacts on their career due to caregiving is dropping. While this is a positive sign, there is a lot of groundwork to do to ensure caregivers have the opportunity to retain their job without undue financial loss or penalty.

Remember that most seniors or near seniors are in denial about their potential need for care and most caregivers sort of fall into their role after an adverse health event of a family loved one. A caregiver’s savings and retirements funds are put at risk when no planning is in place. Planning can help to reduce stress and negative impacts on future caregiver status as well as career success.

If we can help answer questions about planning options available to your or a loved on, please don’t hesitate to reach out by calling us at 1.800.660.7564.

Holding a Family Caregiving Meeting

Holding a Family Caregiving Meeting

A family caregiving meeting is an essential tool when dealing with the care of an aging loved one. These meetings are beneficial for helping to keep all family members abreast of decisions that need to be made, changes in diagnosis or prognosis, and help to ensure that all family members feel that they have a voice. Family meetings can also help to keep caregiving responsibilities from falling solely on the shoulders of one family member. In addition, family caregiving meetings can foster cooperation among family members and lessen the stress associated with caring for an aging loved one.

Who should attend a family caregiving meeting?

There are a number of people who should be included in a family caregiving meeting. First and foremost, it is important to include the aging loved one in the meeting whenever possible. This helps the aging loved one to feel that they are being heard and that their opinions and thoughts are being considered. If a spouse is living, the spouse should be included, as well as any children and possibly siblings of the aging person. Some families may choose to include other family members, but this really varies from one family to another. Anyone else involved in care for the person should also be there. This could include paid caregivers, family friends, or neighbors. Depending on family dynamics, a facilitator can be helpful in running the meeting.

When should a family have a caregiving meeting?

First it is important to note that family caregiving meetings are not a one and done event. They must occur on a regular basis. The first family meeting can occur before an aging loved one actually needs care. This can give the person who may eventually need care more say in their future care, but often times this does not occur. Most families find that the initial meeting needs to occur when an aging loved when begins to show signs of needing care or when a diagnosis is given that determines care will soon be needed. In addition, meetings should be scheduled regular to discuss changes in diagnosis, prognosis, or general needs of the loved one or the caregivers.

How can a family hold a successful caregiving meeting?

The key to having a successful caregiving meeting is cooperation. This doesn’t mean that family members will agree on everything, but it is important that all family members are respectfully heard and considered. Families must be willing to compromise and seek the best plan for their aging loved one. Additionally, a smoothly run meeting should have an agenda and families should try to stay focused on the items included on the agenda. When holding a meeting, always put things in writing and be sure that all those involved get a copy of the important information and everyone’s responsibilities.

What challenges do families face in caregiving meetings?

One of the biggest challenges to family caregiving meetings is the family’s history. All families have their own dynamics that can cause problems in a caregiving meeting. There may be members of the family who are at odds with one another, creating an obstacle to having a successful caregiving meeting. The role that each family member plays can be a challenge. Some members may be overbearing and demand control, while others are peacemakers and do not feel free to share their thoughts. Another challenge is that some family members may be in denial of the severity of an aging loved one’s needs which could make it difficult to get a consensus for care.

Family caregiving meetings are beneficial and necessary when an aging loved one can no longer care for themselves. These meetings can help to divide the responsibilities of caregiving and reduce stress placed on the family members. It is important that families remember that the meetings are for the care of their loved one and cooperate with one another to help the process to run more smoothly and successfully.  If you have any questions about something you have read here about holding a family caregiving meeting, or about anything else, please feel free to contact us at 1.800.660.7564 or email us at info@covertlaw.com.

The Stress of Caregiving on the Sandwich Generation

The Stress of Caregiving on the Sandwich Generation

Dorothy Miller, a social worker, first created the term “sandwich generation” in 1981. A Journalist, Carol Abaya, continued to study and add to what the term means. In 2006, Miriam Webster included the term, sandwich generation, in the dictionary for the first time. The sandwich generation is defined as a generation of people who care for their aging parents while supporting their own children. It is believed that this is occurring because of the increase in life span for adults and also because of delayed parenting. This means that medicine and technology are allowing people to live longer and couples are waiting to start families at a later age. Therefore, leaving people sandwiched between caring for aging loved ones and young children. This can lead to some potential problems for the sandwich generation.

Issues for the Sandwich Generation

One major issue for the sandwich generation is financial burdens. Because many in the sandwich generation may not have anticipated have to provide for the needs of their aging parents, they may be stretched thin financially. Another issue for this group that is often compounded by financial struggle is stress. When pulling double duty of caring for children and aging parents, stress is an understandable and expected side effect. Whatever the living situation of the aging parent, the responsibilities of caring for the aging parent often adds to the already busy schedule related to parenting their own children. The sandwich generation then fills pulled in too many directions. This can often leave them feeling as though they do not have enough of themselves to give to everyone they need which in turn leads to guilt and burnout.

If these issues continue to mount, then depression can become another issue for the sandwich generation. Depression can set in when the sandwich generation has little time for hobbies or social interactions, leaving them feeling isolated. The stress and financial burdens can contribute to feelings of depression. The bottom line is that the sandwich generation must recognize these potential problems and find ways to deal with them. Otherwise they will be ineffective in their care for aging parents and their own children and the pressure will continue to mount.

Dealing with Issues for the Sandwich Generation

In order to be a good caregiver, the sandwich generation must find ways to take care of themselves and to ask for and accept help when necessary. One way for the sandwich generation to find times for themselves is respite care. Respite care provides short-term relief from caregiving responsibilities. Respite car provides a way for caregivers to can find time for themselves and take care of family responsibilities.

Caregivers can plan ahead for tasks and finances to help tackle stress and financial burdens. Having a family meeting to delegate responsibilities to other family members can be very beneficial. This means giving up some things to the spouse and children. Extended family can also help to share the responsibility of caregiving, so meeting with siblings or other involved family members to share the task of caring for the aging parent can help to lessen the burden on one person. Having a close friend to talk to about the struggles can also be a very therapeutic way to deal with the stress experienced by the sandwich generation.

Being a member of the sandwich generation has many challenges. The demands on a person caring for aging parents while also raising their own family can be overwhelming. Self-care is essential to avoiding the pitfalls associated with caregiving. In addition, it is important to remember that it is perfectly acceptable to seek or ask for help in order to maintain mental health and provide good care for everyone.

If you have any questions about something you have read or would like additional information, please feel free to contact us at 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.

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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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