February is American Heart Month

February is American Heart Month, and the National Stroke Association has tools and information that can help you take care of your heart and reduce your risk of stroke.  Never before have I realized the importance of raising awareness of heart health.  Two weeks ago, a dear friend suffered a stroke at the "tender" age of 55.  She had a major risk factor for stroke: atrial fibrillation (Afib)

 

Afib is a condition where your heart beats irregularly.  It is commonly associated with coronary artery disease, heart attack, heart valve disease, cardiomyopathy and high blood pressure. People who have Afib are five times more likely to have a stroke, and about one in six strokes are caused by Afib.  Other risk factors for stroke are similar to those for heart attacks and include:

• High blood pressure
• High cholesterol
• Diabetes
• Atherosclerosis
• Circulation problems
• Tobacco use and smoking
• Alcohol use
• Lack of physical activity
• Obesity

“The link between Afib and stroke is too serious to be ignored by patients who can be effectively treated to prevent a future stroke,” said Jim Baranski, CEO, National Stroke Association. “We want people to be empowered with the knowledge they need to take charge of their health. " You can gauge your personal stroke risk using the National Stroke Association’s “Stroke Risk Scorecard.” According to the association, up to 80 percent of strokes can be prevented. You can learn how to lower your risk by following their stroke prevention guidelines and talking with a healthcare professional about steps you can take to prevent stroke.

 

Stroke is a leading cause of disability in the U.S.  Fortunately, my friend is expected to fully recover.  Sadly, this is not usually the case with stroke victims. Celebrate American Heart Month this February by taking advantage of the programs, tools and information National Stroke Association provides.  www.stroke.org



Thinking ahead

Our New Year's resolutions may already have come and gone but here's one small one that will "pay benefits" down the road if you  just take a bit of time to do it now. 

Have you thought about how you might react if your elderly parent were rushed to the hospital? Be prepared by being proactive!  Minimize the sense of helplessness and urgency by having the proper legal documents in place. The following list is from the National Family Caregivers Association publication, Take Care, Volume 10, #2; Summer 2001.

Durable Power of Attorney for Health Care
Advance Medical Directive
Do-Not-Resuscitate Order
The patient's medical history
A list of patient's allergies
A list of all physicians and consultants (including phone numbers) who are caring for the patient

In addition, keeping a list of your parent's current medications (and dosages) and copies of their insurance card(s) could speed care in an emergency and give you all some peace of mind in the interim.

Excerpt from Buckley's tv interview

http://www.youtube.com/watch?v=IQdAZ2jDpWI&feature=share

www.youtube.com

Recognizing the Need for Outside Help in Caregiving

Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term the caregiver can handle it. Long-term, help is needed.  Outside help at this point is needed.

A typical pattern with an overloaded caregiver may unfold as follows:

• 1 to 18 months - the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
• 20 to 36 months - the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
• 38 to 50 months - Besides needing tranquilizers or antidepressants, the caregiver's physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.

With the holiday season upon us, caregivers feel even more stress -- with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help.  Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.

An article in “Today’s Caregiver” states:

“Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that relieves the stress or provides a bit of respite for the caregiver.
The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.”

It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver. A financial planner, care funding specialist or a reverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times -- the family is experiencing it for the first time.

An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. There are also cash benefits for Veterans, who served during a period of war, that pay for home care or assisted living.

If you are the one providing daily care for a loved one, you owe it to yourself to seek help.
Take care of yourself and your needsm, both physically and mentally.  Seek out professional help that will ease your burden and look for community service organizations that offer respite help.

The National Care Planning Council’s website www.longtermcarelink.net contains hundreds of articles with tips and advice for caregivers and their families.  Take a few minutes to find the help you need and enjoy this holiday season.



The Holidays with Alzheimer's

The Alzheimer's Association offers the following tips to help you and your loved one with Alzheimer's Disease enjoy the holiday season.

Adjust your expectations
No one, including yourself, should expect you to maintain every holiday tradition or event.

• Give yourself permission to do only what you can reasonably manage
• Choose holiday activities and traditions that are most important to you
• Host a small family dinner instead of a throwing a big holiday party
• Consider serving a catered or takeout holiday meal. Many grocery stores and restaurants offer meals to go.
• Start a new tradition. Have a potluck dinner where family or friends each bring a dish

Involve the person in the festivities
There are many manageable activities the person and you can do together, such as:

• Wrap gifts
• Bake favorite holiday recipes together. The person can stir batter or decorate cookies.
• Set the table. Avoid centerpieces with candles and artificial fruits and berries that could be mistaken for edible snacks.
• Talk about events to include in a holiday letter
• Prepare simple foods such as appetizers
• Read cards you receive together
• Look through photo albums or scrapbooks. Reminisce about people in the pictures and past events.
• Watch a favorite holiday movie
• Sing favorite carols or read biblical passages

When the person lives in a care facility
A holiday is still a holiday whether it is celebrated at home or at a care facility. Here are some ways to celebrate together:

• Consider joining your loved one in any facility-planned holiday activities
• Bring a favorite holiday food to share
• Sing holiday songs. Ask if other residents can join in.
• Read a favorite holiday story or poem out loud

With some planning and adjusted expectations, your celebrations can be filled with joy and magical moments to cherish forever.

Brown Bagging It

 A brown paper bag may hold the key to medication safety, according to health experts.

 "A 'brown bag checkup' is the best thing patients can do to avoid medication mistakes and cut down on unnecessary medications," says Douglas Paauw, M.D., Professor of Medicine at the University of Washington.

 The checkup involves putting all of your medications in a brown paper bag and bringing them to your doctor or pharmacist. The bag should include over-the-counter and prescription drugs, herbs, vitamins, dietary supplements, and topical treatments such as ointments and creams. "This kind of checkup is good for anyone who takes medication, but particularly for older adults who are more likely to be taking several medications," Paauw says.

Edie Hurley, nurse manager with Montgomery County Aging and Disability Services, supports the idea of the brown bag checkup. "At least make a list and bring that in," she says.

 Your doctor or pharmacist should check for appropriate dosing, problems caused by interactions between drugs and whether each drug is being given for the right reason.  They should also check for duplication.  It is common for more than one drug to contain the same ingredient.  For instance, taking two products that contain acetaminophen raises the risk of liver damage. Other common problems include expired medications and medications that are no longer needed.

 In one case, an older patient mistakenly thought her diabetes medication was for headaches. "So she took her diabetes medication only when she had a headache, when she should have been taking it every day," according to Hurley.

After you and your doctor settle on what you should be taking, the next thing is to know the names of all of your medications and what they are for. Your list of medications should be updated and reviewed with your doctor each time you change a medication or add a new one.

Experts suggest that you keep a list of medications in your wallet and let a family member know that you have it. Be ready to take that list out at the dentist's office, at appointments with specialists, or in an emergency.

 Another good place to record them is the Vial of Life method. The Vial of Life consolidates basic health information such as medical history, allergies, medications, etc. in one place. It is designed to hang by a red magnet on your refrigerator door in case emergency personnel need to treat you. You can request a free Vial of Life by calling our office.

 Modern medicine has made our lives better in many ways. People taking many different prescriptions need to be aware of potential dangers and take steps to avoid them.

November is National Caregivers Month

Below are some great action ideas in support of caregivers everywhere from "mothers matter/caregivers count":

• Organize and schedule a visit with your local elected leaders and representatives to discuss the issues facing caregivers in your community. Review legislative policies that will provide support. Use these concepts to create a Caregivers Bill of Rights for your state.
• Write a letter to the editor from yourself or your group outlining the importance of economic justice for caregivers in your community.
• Host a "sandwich generation" gathering to recognize the challenges and discuss strategies to help adult children who provide care for their aging parents. Develop an easy-to-do action such as a petition drive directed at your state's elected leaders.
• Create a community forum and invite local home health care providers and other caregiving organizations to discuss the current status of caregiving in your community. Invite policy experts to talk about legislation and initiatives that can help both paid and unpaid caregivers. Develop a plan of action and/or a set of recommendations.
• Start a caregiver awareness group at your workplace to encourage the adoption of workplace policies that include flexible work schedules and paid leave options for employees who are family caregivers.
• Distribute flyers on economic justice for caregivers at local clinics, community centers and care facilities.
• Celebrate/recognize caregivers in your community, in your organization or chapter, and in your family. Host a party to create thank you cards for caregivers. Have members bring the names and addresses of people in the community who take care of others and send them a thank you card.
• Identify a community care center (Residential Rehab Center) or community space and hold a Caregivers Count awareness event. Invite caregivers in the community to a "thank you" event and recognize them with tributes from friends and family members.
• Be present at local town hall meetings and ask your representative what s/he is doing to promote legislation that will help working families, small businesses, and workplaces to develop more family-friendly caregiver policies.

Buckley attends Care Coordination Summit at National Press Club

In her ongoing effort to provide the best possible care management for our clients and to gain valuable insight and tools to improve the performance of her company, Buckley is attending the 3rd Annual Care Coordination Summit presented by Dorland Health where she will

• Hear from leaders who are at the center of healthcare innovation.
• Discuss the strategies organizations are using to improve patient-centered care.
• Share her views and insights on new models of care in a relaxed, open environment geared to enhance learning.
• Identify best practices and models she can apply to improve care coordination from all access points in the post-reform era.
• Analyze the impact of healthcare disparities on effective care coordination.
• Discover opportunities for individuals, organizations and entrepreneurs to share the value they can bring to a disruptive healthcare industry.
• Identify new delivery models, like medical homes and accountable care organizations, and opportunities to improve performance of the healthcare workforce.
• Determine the importance of addressing behavioral health issues as part of holistic care coordination.
• Uncover new strategies to prevent avoidable readmissions.
• Become part of the solution through the Center for Healthcare Innovation.
• Recognize tools and resources that engage and empower patients to be active members of the healthcare team.
• Describe the key role and competencies professionals will need to coordinate care in the burgeoning patient-centered model.
• Apply industry-leading techniques to optimize and ensure efficient use of healthcare resources.

She is excited to join her peers for this unique summit where she will learn from experts at the point of care who are advancing solutions and meeting challenges through innovative best practices.   Look for her to share  more information here after she returns.

Can I Get Paid to Care for a Senior Family Member?

As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many.

The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving.

Seeing a need to give support to family caregivers the federal government Administration on Aging created the National Family Caregiver Support Program.

State Area on Aging division manages this program on the state and community level to offer support services that include:

• Information to caregivers about available services;
• Assistance to caregivers in gaining access to supportive services;
• Individual counseling, organization of support groups, and caregiver training to assist caregivers in making decisions and solving problems relating to their roles;
• Respite care to enable caregivers to be temporarily relieved from their care giving responsibilities; and
• Supplemental services, on a limited basis, to complement the care provided by caregivers.

Medicaid Cash & Counseling Program

A Medicaid approved assistance program called Cash & Counseling may be used to provide funds to hire personal care aides as well as purchase items or services, including home modifications that help them live independently.

The PayingForSeniorCare.com website gives the following information about the program:

"For Medicaid eligible seniors, the process begins with an assessment in the home to determine the senior's home care needs; this includes interviews with caregivers and possibly the senior's physicians. A determination of how many monthly care hours are required is made. The benefit amount is calculated using that determination and cost of care for that geographic area. This amount can be increased or decreased as the senior's needs change. A family care giver may need to qualify as a home health aid by the state to receive these funds."

This program is executed by each individual state Area on Aging Services division. It is a relatively new program and is not yet available in all States. Check with your state Area on Aging Services department for availability.

Using the Veterans Aid and Attendance Pension Benefit

A totally overlooked source of money to pay family caregivers to provide care at home is the Aid and Attendance Pension Benefit. This money is available to veterans who served during a period of war. Pension money is also available to the widows of these veterans. This benefit, under the right circumstances, can provide up to $1,949 a month in additional income to pay family members to provide care at home.

Getting the aid and attendance benefit to pay for family caregivers is not an easy task. This is because there must be a caregiver contract in place, a physician medical evaluation done, income and asset qualifications met and proof of medical expenses provided. Submitting the correct forms and documentation can easily be completed with the help of a VA Accredited Consultant who understands the process.

Long Term Care Insurance Benefit

If the senior being cared for has a long term care insurance policy that covers home care, payment to the care giver from this source could be arranged. Some policies require the care provider to be through a licensed home car agency, but others will pay for individual aides certified as such. This would require some training by the family member to become certified. There are policies that pay a daily benefit amount to the insured to use as they want to pay for their care. Check with a long term care insurance professional about types of policies.

Caregiver Contract

In some cases the senior parent has the funds to pay for care. If a family member is giving care it is very important that a caregiver contract be in place. A signed and dated agreement will outline the services provided as well as the amount of pay for these services. The contract will eliminate questions about what is expected from both parent and caregiver as well as providing a legitimate contract and payment record of services to qualify for Medicaid.

Attorney John L Roberts, in his article titled "Caregiver Contracts that Protect Elders and Their Family Members" states:

"A written Caregiver Contract is a good idea for every family that wants to protect family harmony, and make sure everyone in the family understands how care is being provided to an elder.

The family member who provides care can save an elder from needing nursing home services, and may also protect assets if nursing home care is needed in the future. Elders who want to cover all of these bases must have a written Caregiver Contract. Whenever adult children and other family members are providing valuable care, only a written agreement will protect assets from nursing home care costs and qualify the elder for Medicaid."

In having the parent pay a family member for caregiving, it will be an employer/employee situation and payroll records must be kept with payroll taxes paid.

This can also be set up by an elder law attorney at the time the contract is done.

Final Note

Taking the time to create the caregiver contract, research the government and state services that are available to caregivers and using community resources will make the family caregiving experience less stressful.

"The 4 Steps of Long Term Care Planning" from the National Care Planning Council



SEPTEMBER IS FALL PREVENTION MONTH

Nationally, one third of people over age 65 and half of those over age 80 will fall each year, making falls a serious health threat for seniors. Falls can cause serious injuries like hip fractures, which can mean long-term recovery in a hospital or nursing home, and a reduced quality of life for people who fall.  Falls are also a costly injury. 

In 2009, falls among Maryland seniors resulted in over $225 million in hospital out-patient visits and hospital admissions charges.

About half of all falls happen at home, according to Centers for Disease Control and Prevention data. “One of the most common causes of falls is a home with tripping hazards,” said Odile Saddi, Director of the Montgomery County Area Agency on Aging, “Yet, a few simple steps can make your home a much safer environment.”

To reduce the risk of falls, here are some things you can do:

• Remove things you can trip over (papers, books, shoes) from the stairs and places where you walk.
• Remove small throw rugs.
• Keep items you use often in cabinets you can reach easily without using a step stool.
• Have grab bars put in next to your toilet and in the tub or shower.
• Use non-slip mats in the bathtub and on shower floors.
• Improve the lighting in your home. As we get older, we need brighter lights to see well. Hang lightweight curtains or shades to reduce glare.
• Have handrails and lights put in all staircases.
• Wear shoes both inside and outside the house. If you wear slippers, be sure they fit snugly.

For information from NIH Senior Health on decreasing falls risk, go to http://nihseniorhealth.gov. Search for “Falls and Older Adults” and check out the videos.