One of the many challenges facing adult children of seniors is the conversation regarding finances. In Kiplinger’s Retirement Report, research provided by Ameriprise Financial  shows that no one, no matter their age, does well talking about money. Vice president of wealth strategies, Suzanna de Baca says that the conversation should begin sooner than later, so that needs are addressed as well as anything that might have been overlooked.

According to a Fidelity Investment study, 24% of children feel that they will need to provide financial assistance to their parents compared to 97% of parents who state that they will not need help. Yet, when conversations do actually take place, they, “can dramatically increase peace of mind, reduce anxiety and foster additional discussions.”

For those that worry a financial discussion will cause tension or for those that feel it is not their business to inquire, sitting down and discussing this important issue can put you and your loved ones on the same page.

The Fidelity study found that, “The top barrier noted by 30 percent of parents is they don’t want their adult children to overly rely on a potential inheritance. Additionally, parents who have had detailed conversations with their adult children feel significantly more at ease about their children’s financial future – 68 percent vs. only 30 percent – [than] those who have not had detailed conversations.

 “When asked who they are comfortable with when talking about their financial situation, the study found that both parents (68 percent) and their adult children (60 percent) feel more comfortable discussing with a third-party financial professional than … each other.”

Ms. De Baca suggests using current events to help begin the conversation. By sharing such things as articles and the latest news reports, the conversation can begin with “What do you think?” or “How do you feel about…?”

Once the conversation starts, then ask if they would like for their finances to be reviewed. Maybe you can spot ways to cut back expenses or create income from an immediate annuity or a line of credit from a reverse mortgage. Or, hiring a fee only financial advisor could both help with a cash flow issue, and could protect you and your financial future by suggesting ways to assist your parents.

Some of those ways include paying bills directly, purchasing long term care insurance to cover expensive medical care, assistance with housing, or providing outright gifts of money. According to the IRS, you can give up to $14,000.00 to each parent without having to file a federal gift-tax return.

 Another way to help parents is by looking into federal and state benefits that they could be eligible for. The National Council on Aging offers a free service that helps seniors identify the benefits that best fit their needs. Be aware that with some programs, seniors’ assets and income cannot be above a certain dollar amount. Please check with an accountant or elder-law attorney to ensure that your financial assistance won’t disqualify them.

The post Financial Planning for Seniors and Their Adult Children appeared first on Care for You, Inc..

According to the National Academy of Sciences, the seven yearlong British study, involving 6,500 participants, showed that when physical and mental health issues were taken out of the equation, a deficiency of social contact made a huge overall impact on the state of health.

According to the study’s author, epidemiologist Andrew Steptoe, people living alone in U.S. households make up a quarter of the entire population; increasing from 10% in 1985 to 25% in 2004. A comparable survey from 2010, showed that 25% of Europeans, over the age of 50, interacted with friends and family less than once a month.

The issues of feeling lonely vs. social isolation were both found to impact life span, but once health factors and demographics were accounted for, feelings of loneliness declined and the isolation became more of the focus; isolation being easier to determine due to the number of people the subject matters interacted with.

Last year, a similar study of retired Americans linked feelings of loneliness to many health ailments that include high blood pressure and illnesses of the heart.

That study’s author, John Cacioppo, director of the Center for Cognitive and Social Neuroscience at the University of Chicago, reports that isolation may encourage poor choices in lifestyle, such as lack of exercise, poor eating habits and smoking.

The National Institute on Aging, a division of the National Institutes of Health, Bethesda, Maryland, funded both of these studies. Richard Suzman, director of the division’s behavioral and social research, wonders if feelings of loneliness cause bad health or is it that when one is sick, one gets more lonely; not being able to get out or having fewer visitors. Suzman states that the awareness of isolation and loneliness should increase, much like joint and movement problems and smoking.

The post In-Home Support Can Address Isolation and Loneliness in Seniors appeared first on Care for You, Inc..

Over the past 10 years we have de-cluttered many hoarded homes. Outcomes have ranged from the person moving to an assisted living facility, to remaining in their home and restarting the hoarding cycle, to ‘recovery’ with continued assistance. However, simply changing locations is not a final solution; hoarders exist in independent and assisted living facilities as well.

Yet, in two of our many cases the hoarder was not threatened with eviction. In one case, her coworkers recognized the person was clinically depressed, reclusive, and didn’t want others in her home. Her coworkers worked with her to get help. We were contacted and met with the resident in her North Bethesda home, accompanied by a trusted coworker.  The resident reluctantly agreed to allow her home to be de-cluttered because she realized that her coworker friends sincerely cared about her health, both physical and mental. (It is important to note that hoarding does not favor sex, age or social status.)

Following the de-cluttering, heavy cleaning and structural repairs, the resident declined our proposal to have a companion visit on a regular basis. However, she agreed to a regular cleaning schedule and to periodic visits from a care coordinator. She has subsequently had our computer specialist purchase and install a computer system, conduct remote monitoring, and visit quarterly to answer questions, provide training and perform maintenance.

In another case, the Washington, D.C. home was so badly hoarded the toilets did not work and the water had been cut off for years. The resident frequented a local coffee shop for toileting and “sponge baths”. She has two dogs that she did not allow to go outside as her fence had openings where the dogs could escape. Because of the extent and duration of the hoarding, the home had deteriorated to the point of being seriously contaminated and unsafe. A contractor had to replace a rear deck before the de-hoarding crew could safely begin removing the accumulations.

Concerned neighbors had invited her to one of their homes. During the visit, the neighbors told her they knew she was a hoarder and turned on a television show about hoarding. She was horrified and embarrassed – she thought she’d kept it secret. They assured her that they liked her as a person but were concerned about her hoarding. She agreed to take steps to remedy the situation and called us. Throughout the process, the neighbors have continued their support and encouragement.

Most importantly, the woman has a new lease on life. She still suffers from depression, but has come to realize how much her environment influenced her moods and her entire outlook. The de-cluttering is finished and a new fence has been installed so the dogs can now go outside. Remodeling is not complete although significant progress has been made including installation of all new appliances.

An extensive body of literature exits on the subject of hoarding and obsessive compulsive disorder. Whether reporting on more precise diagnoses, medications or other interventions, the focus is exclusively on the person, not the person in their environment. As we are called on to change and improve the environment, we see the individual within that space. As these two engagements have demonstrated, the person in the middle of that hoarded environment may not always have OCD. “It [is] the light of course that is needed, but it is necessary that the place [have] a certain cleanness and order.”*

*Ernest Hemingway, “A Clean, Well-Lighted Place”

The post Clinical Depression, Obsessive Compulsive Disorder and Hoarding appeared first on Care for You, Inc..

With the lack of sleep or continued interruption of sleep, a patient can suffer from compromised mental ability, a lowered immune system and poor digestion. Once released from the hospital, if these issues are not dealt with accordingly, re-admittance can be required. Statistics are showing that one in five older Americans is re-admitted within the first month of their hospital discharge.  Medicare has become concerned enough about this trend that, starting last October, the agency began withholding  payment for patients readmitted to hospitals with higher-than-predicted readmission rates. These penalties apply in cases of patients readmitted after treatment for heart attack, congestive heart failure, or pneumonia.

Before a patient is released, it is wise also to monitor how they are sleeping as well as their physical ability – especially if an excessive amount of time was spent in bed with no physical exercise. Hospitals have left this responsibility up to the family in the past, but now more are being proactive thanks to organizations like STAAR (State Action on Avoidable Rehospitalizations) and tougher Medicare standards.

STAAR co-founder, Dr. Amy Boutwell, is also President of Collaborative Healthcare Strategies, Inc., which participates in creating programs to improve hospital care and prevent remittance. The programs are being conducted in states that last year began being penalized by Medicare for hospitals that had higher-than-expected readmissions within the first month of those patients’ primary stay.

Since hospitals differ in procedures to minimize readmission, the U.S. Department of Health and Human Services provides an excellent check list to assist someone when it is time to be discharged from the hospital. This guide will help in tracking all that needs to be done – from speaking with doctors and recording medicines to which exercises and what nutrition will be helpful in the recovery process.

The post Innovations to Avoid Hospital Readmissions Among the Elderly appeared first on Care for You, Inc..

Under prior interpretations of the rule, a person could receive therapy as long as continued improvement could be documented. But once the person reached a plateau and was no longer continuing to improve, facilities would stop the therapy out of concern the Medicare program would deny payment. As a result, patients would frequently regress once therapy was halted. Then therapy would be re-initiated and the cycle would repeat.

In an article in The New York Times, “Judith A. Stein, director of the nonprofit Center for Medicare Advocacy and a lawyer for the beneficiaries, said the proposed settlement could help people with chronic conditions like Alzheimer’s disease, multiple sclerosis, Parkinson’s disease, stroke, spinal cord injuries and traumatic brain injury. It could also provide relief for families and caregivers who often find themselves stretched financially and personally by the need to provide care.

“While the settlement is likely to generate additional costs for the government, it might save some money too. For example, physical therapy and home health care might allow some people to avoid more expensive care in hospitals and nursing homes.”

The post Medicare Skilled Nursing and Therapy Services Expanded appeared first on Care for You, Inc..

By eating foods that elevate HDLs, seniors can lower the bad cholesterol, reduce the threat of major health issues and, possibly, have one less prescription to ingest. While foods don’t contain the good cholesterol, there are some foods that, when consumed, increase the efficiency of the HDL level already in the body. To keep HDLs at a high level, it is important to reduce triglycerides, a type of fat often increased by sweets and alcohol. Dealing with vitamin deficiencies, especially vitamin D, will also aid in keeping the HDLs at a good level.

Even a few extra pounds can cause HDL levels to lower, so the dietary recommendation is to eat more soluble fiber. This fiber can be found in fruits, legumes, oats and vegetables. One of the richest sources of fiber is the avocado. The omega 3-fatty acids found in dark green vegetables, e.g., kale, spinach and parsley; deep water fish, e.g., tuna, salmon and trout; soy, and walnuts support the reduction of triglycerides. When too high, triglycerides can reduce the good cholesterol.

Other recommendations include consuming healthy fats for their anti-inflammation properties, such as the mono-saturated and poly-saturated fats found in canola, olive, and peanut oils as well as in avocados. Red wine (in moderation) for the flavonoid and antioxidant properties, a few cups of fresh brewed green tea daily (instant or already mixed bottled is not sufficient) and keeping vitamin D at the proper levels with eggs, fortified cereals and low fat yogurt, skim milk and fish. If vitamin D levels are found to be low, it could take up to a year to get them back to a good level.

To find out your HDL, LDL and vitamin D levels, schedule an appointment with your physician to have blood work performed. The general recommendation for HDL is above 40MG/DL and for LDL is below 130MG/DL. Per the National Institutes of Health, Bethesda, MD, the desirable range for vitamin D is between 30 and 89 IU/100 kcal. Kaiser Permanente suggests a triglyceride level below 150MG/DL.

The post Cholesterol and Aging appeared first on Care for You, Inc..

Mr. Bayne, now 62, entered an assisted living facility at age 53 because of young-onset Parkinson’s. In his article, Mr. Bayne makes several compelling points:

• The notion that this is a resident’s new home is not shared between residents and assisted living management;
• Just because it’s assisted living doesn’t mean it’s compliant with the Americans with Disabilities Act;
• You understand when you go there, that you have checked in ‘for life’; this is most likely where you will die.

The article generated much comment from The Washington Post readers. Most wanted to share their own experiences with a loved one, although some complained that Mr. Bayne was “guilt tripping” them. But let’s examine each of his points.

This is a resident’s new home. As professionals in the field, we have encountered the statement quoted by Mr. Bayne, “This is NOT your home. You lease space here just like everyone else.” Yes, this happens. In our case, it was a conference with assisted living management, the resident (our client), and her three daughters. It is indeed unfortunate that certain administrators will go to extreme lengths to disenfranchise the residents to achieve even greater control and to keep the residents in a continual state of dependency.

In the interest of full reporting, my aunt and uncle spent 13 years in a continuing care retirement community, progressing from independent living to the nursing unit. The care at the intense end of that continuum was incredible. For starters, the facility was carpeted throughout and the staffing ratio was outstanding. When the facility wanted to move my aunt into the nursing wing, she and my uncle refused until they could both go and continue living and sleeping together in the same room. They died in their nineties within six months of one another, but for 13 years they considered the facility their home and no one contradicted them.

ADA compliant. Based our experience, Mr. Bayne’s observations about handicap and wheelchair accessibility, are valid in a majority of assisted living facilities. In fact, many hospitals’ patient rooms are not compliant either. It’s fair to ask, how expensive would it be to have certain rooms with lower sink height for example. Regardless of cost, wheelchair accessibility should exist throughout the facility.

The oppression of watching people die. Like it or not, senior living facilities are, by and large, ghettos, containing a very narrow cohort of the population defined by old age. Yet, just because this is the market the facilities serve, the services do not have to be devoid of energy. Some have experimented with having a pet in residence, and many offer programs of dance, music or other activities. But once a week or once a month is not enough. Activities need to be provided daily.

Tapping into high school community service requirements might be another way to bring youthful energy into the facilities. Sharing stories, playing cards or Scrabble, looking at pictures; the visits would be beneficial to both student and assisted living resident.

Home care is another option that more and more people are choosing. But there will always be some for whom assisted living will be a preferred choice when they can no longer manage on their own at home.

The post Seniors in Assisted Living: One Man’s View appeared first on Care for You, Inc..

Accessible technology is allowing each computer user to address his or her personal needs, whether due to limitations caused by aging, language and learning impairments, or physical disabilities. Having this technology is a win-win situation for business as it serves the customer, helps the employee, and maintains good relations with partners.

According to the results of a study commissioned by Microsoft, between 2003 and 2004, 57% of computer users 18-64 years old would benefit from using accessible technology. Even though the participants did not admit to having any diminished abilities, Forrester research found that one out of five experience hearing issues, one out of four experience pains in wrists and/or hands and one out of four experience problems with vision. According to another source, almost one in seven of the world’s population has some type of learning disability.

The fact that our global population is growing older and working longer is requiring our technology to become more accessible as well. Countries like Japan will have 30% of its workforce over the age of 65 by 2020. By 2018, more than one fifth of the United States’ working population will be over 55, and by 2050, 45% of the European workforce will be 65 years or older.

With technology being more accessible, businesses can retain older employees who might otherwise have to retire due to age related issues. Additionally, businesses can recruit employees with physical disabilities thus proving that they have everyone’s best interest at heart  –  creating loyalty among customers and employees.

Microsoft addresses six different impairments or disabilities – age related, hearing, language, learning, mobility and vision. They also show how to access the means to make computer usage more user friendly. With each of these issues Microsoft has given a list of recommendations: Everything from changing the size of text and icons, to having a screen reader or braille printer, to making the mouse and keyboard optional for computer use.

With the help of Microsoft, experts at technical centers and in occupational therapy can get the advice and training needed to address current disabilities and plan for the future. Age does not have to be a barrier to continuing one’s career, or choosing a pastime involving technology. These are exciting times for young and old alike. Technology clearly is helping change the definition of what is means to be a senior or disabled.

The post Making Technology Available To Everyone appeared first on Care for You, Inc..

In a recent Wall Street Journal article, writer Shirley S. Wang reported that medical science is finding more and more that psychological disorders are showing up as diseases in the body, not just in the mind. Diseases that would normally be associated with old age are showing up in younger individuals who have dealt with or who are dealing with depression, psychological stress and post – traumatic stress disorder for long periods of time. To name a few, these diseases include dementia, diabetes, heart disease and hypertension. (An earlier article, Mental Health in Later Life: A Guidebook, may be found on the Care for You website.)

At the cellular level, chromosomal changes are speeding up; better known as “accelerated aging”. This is alerting science to look at emotions as a symptom of the psychological issues affecting the body. Mood will be looked at as an indicator of some larger health problem.

According to Dr. Owen Wolkowitz, psychiatry professor at the University of California, San Francisco, we as a society will no longer look at depression as a mental illness. Along with his research colleagues, Dr. Wolkowitz wants to understand the connection of the mental with the physical so as to provide a better diagnosis/treatment of mental illness and help improve the memory of those with cognitive problems.

Recent studies are looking at the protective coverings at the end of chromosomes as indicators of problems. These coverings are called telomeres and as one ages, they become shorter. Clinical studies at UCSF and in Sweden show similar results in that there is a link between depression and the length of this protective covering.

Scientists and researchers want to continue working to find out how serious the psychological episodes must be to shorten the telomeres, as well as the genetics’ vs. life events’ effects on age-related diseases and why some stressed people don’t experienced shortened telomeres.

The enzyme telomerase protects the covering’s length and through research, Dr. Wolkowitz’ team has determined that some people have biological capabilities to produce higher anti-inflammatory proteins and antioxidant levels.

Lifestyle changes can also increase the levels of this enzyme, as proven by research involving patients diagnosed with prostate cancer. Dr. Dean Ornish, creator of the Preventive Medicine Research Institute, along with UCSF’s research group, worked with this group and after three months found that telomerase levels had increased. The increase occurred after lifestyle changes were made – including lowering psychological distress and cholesterol.

Since telomere length can be determined through a blood sample, current research at UCSF is comparing the test results of study participants with those of average people of the same age. Researchers will be tracking these participants to see if, after given this information, they have a greater desire to improve their lifestyles.

The post Depression Can Affect More Than Just The Brain appeared first on Care for You, Inc..

For people who are bedridden, common places for pressure sores are the back or sides of the head, rim of the ears, shoulders or shoulder blades, hip, lower back or tailbone, heels, ankles and skin behind the knees. For people who use a wheelchair, common places for pressure sores are on the buttocks, shoulder blades, spine, and backs of arms and legs where they rest against the chair.

Per the Nursing Home Abuse Center and others, there are four different stages of pressure sores.  A doctor should be consulted when any of the following symptoms are evident.

Stage I – The beginning stage of a pressure sore has the following characteristics: The skin appears red on people with lighter skin color, and the skin does not briefly lighten when touched. On people with darker skin, there may be no change in the color of the skin. The skin may appear ashen, bluish or purple, and does not briefly lighten when touched. The site may be painful, firm, soft, and warmer or cooler compared with the surrounding skin.

Stage II – The pressure sore is an open wound with damage to the outer layer of skin and part of the underlying layer of skin. The pressure sore may appear as a shallow, pinkish-red, basin-like wound. It may also appear as an intact or ruptured, fluid-filled blister.

Stage III – The sore is a deep wound, the loss of skin usually exposes some amount of fat; the ulcer has a crater-like appearance. The bottom of the wound may have some yellowish dead tissue. The damage may extend beyond the primary wound below layers of healthy skin.

Stage IV – The sore exhibits large-scale loss of tissue, the wound may expose muscle, bone and tendons. The bottom of the wound likely contains slough or dark, crusty dead tissue. The damage often extends beyond the central wound site below layers of healthy skin.

MedlinePlus, a service of the National Library of Medicine in Bethesda, Maryland, references an excellent article  that speaks to recognizing, preventing and caring for pressure sores or ulcers. The article offers advice in several important areas:  

• Skin Care (for intact or normal skin)
• Moving and changing position
• Nutrition and Hydration
• Relieving pressure on the area near the ulcer.

Communication and close coordination with the medical community are extremely important in dealing with pressure sores: first, to prevent the pressure sores from occurring, second, to recognize them early on, and third, to aggressively manage them when found.

The post Pressure Sores: What are They and Why are They Important? appeared first on Care for You, Inc..