Monday
Jun112018

World Elder Abuse Awareness Day 2018 - Friday 6/15

Each year, an estimated 5 million older adults are abused, neglected, or exploited. Older Americans lose an estimated $2.6 billion or more annually due to elder financial abuse and exploitation, funds that could be used to pay for basic needs such as housing, food, and medical care. It, unfortunately, occurs in every demographic and can happen to anyone—a family member, a neighbor, even you. It is estimated that only one in five of these crimes are discovered. 

Please take a few minutes to write your local newspaper to advocate on behalf of our at-risk elders.   A sample letter to the editor is below:

Dear Editor:

Friday, June 15, 2018 is World Elder Abuse Awareness Day. On that day, communities in the USA and all over the world will sponsor events to highlight solutions to this systemic social challenge.

As Americans, we believe in justice for all. Yet we fail to live up to this promise when we allow older members of our society to be abused or neglected. Older people are vital, contributing members of American society and their maltreatment diminishes all of us. Just as we have confronted and addressed the social issues of child abuse and domestic violence, so too can we find solutions to address issues like elder abuse, which also threatens the well-being of our community.

Our policies and practices make it hard for older people to stay involved with and connected to our communities as they age. As a result, older people are more likely to experience social isolation, which increases the likelihood of abuse and neglect. We can design stronger societal supports to keep our older people connected and protect them from abuse, whether financial, emotional, physical or sexual. When we address a root cause, like social isolation, we also make it less likely that people will neglect themselves (self-neglect). Older adults who are socially connected and protected from harm are less likely to be hospitalized, less likely to go into nursing homes and less likely to die.

We can and must create healthier and safer living environments for older adults, including their homes, nursing homes, and assisted living facilities.

Get more information about how to make a difference by visiting the National Center on Elder Abuse https://ncea.acl.gov or by calling the Eldercare Locator at 1-800-677-1116 to explore local community services and supports.

Tuesday
Jun052018

Older Adults and Romance

Some words of wisdom here from The Hook Law Center's newsletter.

It is no secret that American families come in all shapes and sizes.  Gone are the days when a family consisted of a husband and wife who have only been married once and their children from that marriage.  Much research has been done on blended families at any age but not much information exists on older adults and relationship.  Indeed when the issue arises, many families (adult children and grandchildren) are shocked that romantic relationships are a concern.  Yet, romantic relationships and the resulting intimacy and companionship can vastly improve the quality of life for many older adults.  However, the relationship may also require some legal planning to protect all involved.

 

There are trends with relationships among older adults which may surprise many (especially their children).  One such trend is a coupling where the partners cohabitate but choose not to get married.  In times past, this arrangement may have been seen as unusual at best and judged harshly at worst.  However, since 2007 there has been a 75% rise in the number of couples where the parties are 50 or older in the United States who live together but who choose not to get married.

The reasons for the choice vary widely.  For some, the possible loss of pension benefits or health insurance benefits from a prior spouse provide a financial incentive to avoid remarriage.  For many who have been divorced, they look at cohabitation, commitment, and personal happiness as more valuable than the ceremony.  In addition, there is less risk in that they are not legally responsible for the debts of their cohabitating partner, but they would be responsible for the debts of a spouse.  For many, women in particular, cohabitation offers financial stability in that there is a combination of incomes to support the household, but no risk of loss of assets which were accumulated with a prior spouse.

In addition, to the many couples who choose to cohabitate, there is a trend emerging known as “living apart together.”  This refers to couples in loving and committed relationships who desire to remain committed but who do not want to get married or cohabitate.  Unlike the dating relationships of most younger adults, where dating is a step on the way to marriage, these couples see no need for anything beyond the commitment.  As for those who choose to cohabitate, the reasons for this vary widely.  Some have been through devastating divorces and do not want a similar entanglement.  Others don’t want the crowded feeling that accompanies another living in the same space and they want to maintain separate social circles and events.

From a legal perspective much emphasis is placed on careful planning for married couples.  However, for couples in alternative arrangements, planning may be even more important.  For many older adults in alternative arrangements, they want their non-spouse partner to make medical or financial decisions for them in the event of an incapacity or they may wish for their partner to make medical decisions but other family members to make financial decisions.  Whatever the desire, appropriate legal documents must exist so that wishes are clearly expressed.  It can also be helpful to let all parties, especially adult children who may expect to take on certain roles, to know the express wishes of the individual prior to a medical crisis or incapacity.  Failure to do can result in negative feelings between parties or, in some cases, contested litigation over who should be allowed to make certain decisions.

Being an older adult does not preclude a romantic relationship and, if you are an older adult in an alternative relationship, you are not alone.  Relationships can take on a variety of appearances, all of which can contribute to a happy and positive old age.  However, some legal planning is recommended to protect all involved.

Tuesday
May222018

Geriatric Care Managers: What They Do and Why You Need One

What is the difference between Medicare and Medicaid? What is a health care proxy? Does Medicare pay for long-term care? What care options are available to meet the specific needs of my elder family member? What happens when they are discharged from the hospital; where will they go? How can I most effectively advocate for them?
Do you know the answers to any of these questions? You might, but chances are you don’t know the answers to all of them. Much like Sherpas guiding outsiders up the slopes of dangerous mountains, Geriatric Care Managers help elders and their families navigate the confusing and often overwhelming field of elder care options. Think back to the first time you bought a house (or if you haven’t, then picture one of those house-hunting TV shows). Did you use a real estate agent? You probably did, and you did so because you know next to nothing about the real estate market and wanted to make sure you got the best deal on your house. Your real estate agent learned your specific needs and desires, surveyed the market, and, using their expertise, curated a list of available houses that best suited your needs and means.
 
In a nutshell, that’s what a geriatric care manager does in the world of elder care. A care manager will first meet with the elder and/or their family to assess their situation, needs, and means. They will then survey the care options available and present them to you for you to choose from. However, their services don’t end there. A key aspect of the job of a geriatric care manager is to monitor the elder once situated in their care environment and advocate on their behalf when necessary. Like buying a house without a real estate agent, managing your family member’s care isn’t easy and can be extremely stressful.
As Jane Gross put it in a New York Times blog post:
“During one especially dicey period with my mother, then in an assisted living facility, my brother and I hired a geriatric care manager, first for a consultation and then for additional help at an hourly rate. It felt like such an extravagance, given that we weren’t rolling in money, but the care manager helped solve a series of complex problems that I doubt I’d have solved by myself, mostly involving brokering a compromise with the facility, whose management wouldn’t let me hire a private aide for my mom but could not provide what she needed.
Relations had soured to the point that all I could do was scream at them, which was making a bad situation worse, so having an advocate was a blessing. Also, the care manager, who visited regularly with my mother, often was privy to concerns she was keeping from me, and she was always there for me by telephone, which was a lifesaver.”
Geriatric care managers have many tools in their belts. They advocate, they help cut through the confusion of elder care options, and furthermore, they are your connection to the universe of senior care options and services. Do you need an attorney to draft or edit a will, durable power of attorney, or health care proxy (or even to tell you what any of those are)? Your geriatric care manager probably knows an attorney who can help you with that. Looking to sell Mom’s house so she can downsize? Your care manager probably knows a real estate agent who can get the property listed. If it sounds like geriatric care managers are jacks-of-all trades, that’s because they are. And they can be an invaluable resource for helping you through a potentially overwhelming situation. 
Jane Gross’ Blog Article
https://newoldage.blogs.nytimes.com/2008/10/06/why-hire-a-geriatric-care-manager/

 

Monday
Apr302018

Companion Care Services: What They Are and What They Aren’t

 

As the Baby Boomers, the largest generation in history before the Millennials, retires and moves into the next phase of life, the need for elder care services is only going to increase over the coming years and decades. For the children of these aging retirees, the array of senior care services, the different types and levels of care, can seem dizzying. There is amazing choice in the senior care market today, with almost every type of treatment plan imaginable. However, this can be intimidating to the uninitiated. Let’s begin with examining a growing, extremely useful, multifaceted senior support service: companion care.

 

First, let’s be clear on what companion care is not. It is not medical care of any kind. Companion care workers are not necessarily medical professionals and they do not provide any kind of medical service or diagnoses. However, in their own way, they contribute to the quality of life of seniors all over the country. It’s a sad fact of life that, as we age, we can become more and more isolated. Families spread out, friends move away, or pass away. Growing old isn’t easy. And sometimes all a senior wants is a companion, a friend, someone to talk and interact with.

 

Companion care offers a warm, friendly presence in a senior’s life. They can help with groceries, other errands, and take seniors to doctor’s appointments, or almost anywhere else a senior might need to go. While these services may seem simple, the value that they provide cannot be understated. These are all activities that, were it not for a companion care worker, a senior would be doing alone, or unable to do at all. They preserve a sense of independence, going out with a friend, just like they always used to do. While medical services are always going to be in high demand, sometimes the last thing a senior wants to see is another doctor or nurse or therapist. Companion care is a much more relaxed service.

 

Companion care professionals also serve as eyes and ears for family members who may not always be able to check in on their elderly relatives as much as they would like. Families move away, but the needs of the elderly family members remain. Companion care professionals, who interact with seniors on a daily basis, know what to be on the lookout for. While they don’t make diagnoses, a companion care professional is a regular presence in the senior’s life, and can alert other family members when things seem off.

 

Companion care services are what they sound like. They are the services of a friend. They are a regular, friendly, watchful presence in a senior’s life. They provide the most basic level of non-medical senior care and can be a good first step as relatives begin to age and can give them more quality time at home before other senior care alternatives become necessary.

 

Tuesday
Jun072016

World Elder Abuse Awareness Day

June 15th is World Elder Abuse Awareness Day.  According to the National Center on Elder Abuse, millions of older persons are abused, neglected, and exploited. Once a year in mid June, communities and municipalities around the world plan activities and programs to recognize World Elder Abuse Awareness Day (WEAAD). It’s an opportunity to share information and spread awareness about abuse, neglect, and exploitation in later life. Everyone can make a difference. Take a stand against elder abuse with the actions steps suggested below:

Engage Seniors

Empower Communities

Speak Out!

Involve Youth

  • Ask your teacher to commemorate World Elder Abuse Awareness Day on June 15 by educating students on the signs of elder abuse!
  • Create an art, essay, or poem contest for kids about the value and respect of elders!
  • Have your sorority or fraternity do a service project to help elders. Visit a nursing home or senior center and pass out education materials from the World Day Tool Kit. Visit isolated seniors in your neighborhoods.
  • Encourage your teen to start a campaign to promote dignity and support for older adults External Web Site Policy.


Join an event! See what events are happening in your community. If there are none so far, consider starting one, or contact your local Area Agency on Aging to see what local coalitions are doing.

 

 

 

 

Thursday
Dec172015

Tips to Reduce Loneliness During the Holidays

The holidays are often a difficult time for older adults, especially shut-ins.  For many, family members have grown up and moved away and often are too busy or don’t have the funds to travel for the holidays.  Add to that, thoughts of loved ones who have passed away, mix in a bit of seasonal affective disorder and you have a recipe for depression. 

Pam Marra, staff writer for Theet.com, offers the following very practical tips to help reduce the loneliness that many of our older adults feel at this time of year.  

  • Spend time with them. Look at holiday photos or videos with them, and leave them photos to view when they’re alone. Let them reminisce. 
  • Listen and understand when they want to talk, even if the talk is negative. 
  • Help them focus on the good things present in their lives rather than their losses. 
  • Holiday cards often bring bad news, and decrease in quantity. Help them write their own cards to keep a connection with life-long friends. 
  • If a parent is in an assisted living facility or nursing home, check with the local kindergarten or day care centers to see if they can bring children to visit.
  • Check with parents’ churches or spiritual facilities. Visitors, such as those in the Stephen Ministries, a program many Christian churches offer, can visit people at home or in a facility.
  • Decorate their home or room in stages, presenting cherished ornaments at intervals so there is something to look forward to. 
  • Bring traditional baked goods or treats regularly for them and their friends to share. 
  • Call their friends and see if they can come to a small gathering or party. 
  • Make their dinner table special. Whether at home or in a facility, try to make the table festive with some appropriate colors and themes. 
  • Remind them how important they are. They may feel useless and burdensome. Make them feel loved. 

 

Wednesday
Jul152015

Where should we keep our estate planning documents???

Our friends at Hook Law Center have written a great article below on how best to store your estate planning documents.  Hope you appreciate the information as much as we did!

You likely are aware of the importance of having comprehensive, up-to-date estate planning documents. What you may not realize, however, is that where you keep your original documents can be equally as important – and can either help your loved ones out immensely, or can cause them to incur significant legal fees.

A complete estate plan includes documents which are to be used in the event of your incapacity as well as at your death. In both of these situations, it is important that the individuals named to serve in those documents are aware that the documents exist, where they are located, and how they may be accessed. After all, if the original documents cannot be found, they will be of little use. A beneficiary of a will whose original that cannot be located, for example, may be out of luck, if the beneficiary would not have otherwise inherited under Virginia’s laws relating to intestate succession. The law presumes that if an original will cannot be located, its creator destroyed it with the intent that it be revoked. As a result, attempting to admit a photocopy of a will to probate can be a costly, time-consuming endeavor, and there are no guarantees as to whether the copy will ultimately be accepted.

To avoid the problems that arise when original estate planning documents are lost, we recommend the following:

(1) Store your original estate planning documents, and any other important legal documents (deeds, life insurance policies, etc.), in a safe, secure, and logical location.

Many people choose to store their documents in a waterproof and fire-resistant safe or file cabinet at home; others prefer to keep theirs in a safe deposit box at the bank. These are all good options. We do not recommend storing original documents in your car, the freezer, a basement that floods, or in one of the many banker’s boxes you have sitting in your garage. Help your loved ones out by choosing a logical location.

(2) Ensure that others will be able to access your documents in the event of your death or incapacity.

If you are keeping your documents in a safe at home, make extra copies of any safe keys and combinations. If you are keeping your documents in a safe deposit box, work with the bank to ensure that a trusted family member or friend can access them in the event of your death or incapacity.

Under Virginia law, an agent under a power of attorney does not have the automatic right to enter into and remove all contents of a safe deposit box, although the agent may be permitted to enter into the box for the limited purpose of searching for the original power of attorney. For this reason, safeguarding the documents yourself or having a trusted family member safeguard them may cause fewer headaches for your fiduciaries. If you choose to use a safe deposit box, we generally recommend that it be in the name of joint owners, so that the joint owner may be able to access the contents of the box in the event of your incapacity or death. Always check with your bank, however, to ensure this will be the case. Each bank’s policies and procedures may vary.

(3) Tell the individuals named in your estate planning documents where you are keeping the originals and how they may access them.

It is a good idea to do this in writing, so the information is not forgotten. If you store your documents in a safe, be sure your named agents and executor have the combination or a copy of the key. If the documents are in a safe deposit box, make sure your named agents and executor know the box number and the address of the bank branch where the box is located. If you change the location of your documents, update your loved ones immediately to make them aware of the new location.

(4) To avoid confusion, shred any old, revoked estate planning documents.

You don’t want your loved ones to run across – and attempt to use – an outdated will or power of attorney that no longer reflects your wishes. Prevent misunderstandings and family conflicts by keeping only your current estate planning documents.

 

Wednesday
Apr082015

Avoiding "the Fall"

Fairfax County's Independent Living Project recently sponsored a presentation by Margie Fox Kwart, a Certified Aging-in-Place specialist and Occupational Therapist.  The summary of her presentation follows with credit to NorthwestMedical.com and PattersonMedical.com.

Besides any preconceived notion that falls are simply the result of poor balance, weakness, or accidental tripping over objects - it is important to realize there are many other components that may contribute to falling. Seek out the appropriate specialist to address the following factors which can contribute to an increased number of falls:

Numerous medications

Vision

Arthritic pain

Foot Problems

Balance skills

Incontinence

INDIVIDUALLY, WE CAN CONTROL THE FOLLOWING AND REDUCE OUR RISK OF FALLING:

Sleep habits

Nutrition/Diet Behaviors related to substance abuse

Hydration

Willingness to use equipment Footwear (i.e. walker, wheelchair)

Techniques for completing tasks

Risk Taking

STRONGLY EMPHASIZE THE NEED TO:

Increase visibility - Stronger/enhanced lighting - on floors, walls, hallways, stairs, countertops, desks

Contrast - to emphasize what is important and to differentiate it from the background

Reduce Glare

Add Textures and Non-skid Surfaces on handrails, grab bars, flooring 

Reduce Clutter – a true health hazard both inside and outside the home

Ensure safe accessibility - Make sure what you need is accessible - both indoors and ourdoors: Must be able to easily access light switches, outlets, mailbox, counters, shelves, dishes, pots & pans, closet hooks and rods, faucets, furniture (accessible height), objects used for daily living tasks (i.e. toilet paper rolls), doors (lever handles), elimination or reduction of thresholds (when entering and exiting the home as well as individual rooms.)

SOME OF MY FAVORITE SIMPLE & ECONOMICAL HOME SAFETY MODIFICATIONS INCLUDE:

LIGHTING:

-Stick on motion sensor LED lights especially on stairs, or to add as task lighting (i.e. under cabinets, in closets and drawers)

-Place a ‘touch night-light’ for use on night stand

-Frosted bulbs and sheer blinds reduce glare

-‘Reveal’ light bulbs simulate natural light

CONTRAST:

-Paint or colored duct tape to provide contrast (especially to mark stair edges, countertop edges, and to differentiate wall from floor)

HANDRAILS AND GRAB BARS (should have texture and should contrast from wall color):

-Add a second stair handrail on opposite side of existing rail

-Add handrail along a hallway – (especially leading to bathroom or other common paths)

-Add an extension to an existing stair handrail so that it leads you onto a flat surface or landing, beyond where the normal rail ends

AUTOMOBILE ACCESSIBILITY:

-‘Swivel seat cushion’ (lazy-susan concept) to ease getting in and out of car

-‘Handybar’ - compact and portable to ease standing up from car seat -3-

KITCHEN:

-Perching stools - adjustable in height and enable you to sit for tasks

-Carts on wheels- to transport dishes and pots

-Slide-out under cabinet shelving for greater accessibility

-Hang pots and pans on hooks within reach

BATHROOMS:

-Bathroom doors should open OUT (for quickest access to a person who may have fallen and landed on the opposite side of the door)

-Professionally install grab bars – do not use suction type; should have contrast and texture. Many variations available depending on where and how used – (i.e. tub, toilet, bed)

-Shower seats - many varieties available depending on individual needs

-‘Tub Cuts’ – to turn a bathtub into a walk-in shower. These are reversible and applicable to most bathtub materials

-Replace sliding glass doors with a shower curtain

-Toilet seat height – add seat risers, add arms, and/or consider ‘toilevator’ to elevate from the base

-Place bar of soap in old pair of pantyhose and attach to soap dish to avoid having to retrieve a dropped bar.

ACTIVITIES OF DAILY LIVING:

-Adaptive equipment is available for just about any challenge related to self care. Products are designed to enable greater independence and safety (i.e. long handled reachers, shoe horns & bath sponges; elastic shoe laces; adjustable height shower hose; leg lifters to assist getting legs on and off of bed).

-‘Life alert’ monitored and non-monitored systems for emergency calling with one touch

CLUTTER:

-Eliminate loose cords on the ground by holding them together with a paper towel roll

-Take boxes of old photos and have them made into a (digital) photo memory album

TEXTURE:

-Roll-on ‘anti-slip flooring products’ for indoor and outdoor use

-‘Serfas Grip Bar Tape’ and other such products cab add grip-ability and texture to rails and bars

FLOORING:

-Ideally eliminate or minimize thresholds in and around the home

-Portable thresholds and ramps are available for easier access into the home -Remove scatter rugs wherever possible

-Ensure rugs are held securely to the floor, especially around the edges, using carpet tape

-Minimize bold prints and patterns on the floor.

MISCELLANEOUS:

-Attach a bell to the collar of your pet to alert you that s/he is approaching

-Place a table by the front door to have a place to rest packages

-‘Furniture Risers’ – place under beds, chairs, etc. to elevate seat height

Thursday
Jan222015

Managing your LTC insurance policy

Buckley has long advocated acquiring Long Term Care Insurance policies for our later years.   If you have purchased such a policy, here is some excellent advice from our friends at The Estate Planning & Elder Law Firm:

Many people have difficulty getting benefits under their long-term care insurance policies.

These disputes have often related to the interpretation of a policy when language is unclear or ambiguous. Although occasionally it is necessary to employ an experienced elder law attorney when negotiating and managing a long-term care insurance policy, the best practices discussed in this article will hopefully help you avoid legal fees and lost benefits.

I. Actively Manage The Policy During A Policy Transfer

Since 2008, some insurance providers have experienced corporate transitions, dissolutions, and bankruptcies. Occasionally, a specific set of policies is transferred from one company to another during a corporate transition. When this happens, be sure to properly document the policy’s transition from one company to another.

Usually, the new company will have the same rights and obligations as the prior company, since the policy will have only been “assigned,” and therefore has not been contractually altered. However, any paperwork regarding the transfer may include “fine print” which is important to review with a critical eye. Sometimes a state insurance bureau will allow a company receiving a policy during a transfer, known as the assuming company, to raise the premiums on the policy in order to ensure that the set of policies has sufficient liquidity coverage.

II. Watch The Rating Of The Company

Although over a hundred companies in the United States offer long-term care insurance, only a fourth of these companies have healthy financial strength ratings. There are also numerous rating agencies, the foremost of which are A.M. Best, Moody’s, and Standard & Poor’s. It is a good idea to review the financial strength of the company underwriting your long-term care insurance policy. This should be done at least once a year. If a company has a dramatic ratings change, it is possible that it is experiencing a financial crisis. This could lead to a transfer of your long-term care policy to another company. The earlier you learn of the potential bad news, the more time you have to adjust your plans around it.

III. Document With Whom You Are Speaking And What They Specifically Say

As with any legal contract, usually a long-term care policy is interpreted solely through the written words of the policy itself. Thus, when a representative tells you something about a policy, make sure they explain where in the policy it specifically states their position. Be sure to write down these statements as well, so that if an attorney has to review your matters, you can properly document what was said or not said. Moreover, some long-term care insurance companies now allow a policy holder to email them their questions.

IV: A Closing Comment

Please note that our experiences with long-term care insurance have been positive overall, and we still believe that it is a good product for many people – as long as the policy fits into the overall financial plan of the client and is underwritten by a strong company. Long-term care is incredibly expensive when paid for out-of-pocket, and it is hard to predict the political climate and future legislation which could alter federal benefits programs. However, it is important to consider utilizing an attorney to make your initial claim for benefits under a policy. Even if you are already in an assisted living facility, a company can claim that you are not impaired to the extent necessary for benefits to accrue under the policy. An attorney may be helpful when you transfer from one form of care to another. For example, even if you are already receiving benefits for in-home care coverage, a company may claim that an additional exclusionary period applies when you transition to an assisted living facility. It is usually much more beneficial to enlist an attorney prior to a claim for benefits than after it has been filed.


Wednesday
Nov122014

10 Great Ways to Support Family Caregivers

Many Americans recognize November as a month to thank, support, educate and celebrate all the many caregivers nationwide who provide loving care for family members free of charge.  Such services are estimated conservatively to be $306 billion annually.

Our friends at Right at Home offer the following suggestions as ways to celebrate National Family Caregiver's Month:

  1. Offer a few hours of respite time to a family caregiver so they can spend time with friends, or simply relax.

  2. Send a card of appreciation or a bouquet of flowers to brighten a family caregiver's day. 

  3. Encourage local businesses to offer a free service for family caregivers through the month of November.

  4. Help a family caregiver decorate their home for the holidays or offer to address envelopes for their holiday cards. 

  5. Offer comic relief! Purchase tickets to a local comedy club, give a family caregiver your favorite funny movie to view, or provide them with a book on tape. 

  6. Find 12 different photos of the caregiver's family and friends. Have a copy center create a calendar that the family caregiver can use to keep track of appointments and events. 

  7. Offer to prepare Thanksgiving dinner for a caregiving family in your community, so they can just relax and enjoy the holiday. 

  8. Take a few minutes to write a letter. Encourage your faith community to ask for prayers not only for those who are ill, but also those who care for them. 

  9. Encourage family caregivers to become a part of the National Family Caregiver Story Project. It's a great place to not only share but read about others in like situations. 

  10. Help a family caregiver find new educational materials and support through family caregiving web sites or by calling local social service agencies for help.