Paying The Cost of Care

As we learned in the previous sections, informal caregivers are family members or friends who take care of loved ones typically without being paid for their services.  Formal care givers are paid professionals or volunteers from aging organizations.  Whether they are reimbursed for their services or not, formal care givers receive some sort of funding either as wages or salary or for administration of their support group.

As care needs increase, both in the number of hours required and in the number of intensity of activities many requiring help, there is a greater need for the services of formal care givers.  Unfortunately, many informal care givers become so focused on their task they don't realize they are getting in over their heads and they have reached the point where some or complete formal care giving is necessary.  Or the informal care giver may recognize the need for paid professional help but does not know where to get the money to pay for it.

It is the job of a care manager or a financial adviser or and attorney to recognize this need with the client care giver and provide the necessary counsel to protect the care giver from overload.  The advisor can also likely find a source for paying for formal care that the care giver may not be aware of

As mentioned in previous posts Intermittent Care would require the occasional attention of an informal care giver but there may also be a medical condition that may require expertise and informal care givers does not possess.  As a general rule most people receiving this kind of care would probably be in their own home and the care giver would be living or working close by and stop only for occasional visits.

There is, however a growing trend where the only family care givers may be living hundreds or thousands of miles away from their loved one.  In this case, a care manager would be hired to arrange for the intermittent care for the loved one.

This could still be furnished by an informal care giver assuming there is not extensive medical condition requiring frequent attention.  It is more likely under this scenario the patient and the informal care giver would be living together.  Or with no care giver available a decision would have to be made whether it would be in the best interest of the patient to receive formal care in the home or to go to a care facility.  Oftentimes a care facility can offer a better environment at a lesser cost.  On the other hand, many patients prefer to remain in their homes at all costs.  And for long distance care givers, hiring a care manager is still the best option. In my next post I will discuss full time care and various options for patients.

One Stop Shopping For Eldercare Services

A fast growing generation of elderly people needing care is starting to put a great deal of pressure on care giving family members. More and more we are seeing articles and books about the burden of long term care on families.

According to research by the National Care Planning Council, only about 16% of long term care services are covered by the government. The other 84% are provided free of charge by family care givers or provided by services paid out of pocket by families or from those receiving care. The council also estimates that at any given time approximately 22% of the population over age 65 is receiving some form of long term care support. About 44.4 million adult care givers provide 21 hours a week of care with 4.3 years average time spent providing care.

The need for care usually occurs without warning, when a stroke, heart failure of other medical condition or illness incident to age suddenly happens to a aging senior. Family members end up in panic mode trying to understand and educate themselves on what needs to be done and what resources are available. If they need to take time from work to handle the crisis then it becomes urgent to find answers and solve care giving needs. The need to balance work with urgent care giving responsibilities creates untold stress on employed family care givers.

Most family care givers simply don't know where to turn for help and advice. Long term care services are complicated and provider contacts are fragmented throughout the community. For the majority of Americans, elder care becomes a frustrating do it yourself process How do you find out what government services are available and what they will pay for? /what legal documents are necessary and how do you protect assets? What type of home Care or facility care is needed? Should you quit your job to become the care giver? Will the government or insurance pay you for care giving to help you replace your lost income?

There are many places to find out the information you need to know. Perhaps the best is your State Area Agency on Aging. They have a wealth of information and in many states counselors

to help you work your way through the system.

I am more than willing to provide advice to Arizona residents who are seeking information about the various options and reimbursement systems that are in place. You can post a comment or e-mail me at TRF649@aol.com. But the truth of the matter is that programs and reimbursement systems are different from state to state.

Keeping Mom and Dad Safe at Home

Generally, elderly parents want to remain living in their own home. However, reaming in the home becomes a concern when children see their parents slowing down, perhaps even having trouble handling stairs and doing general daily activities. Yet, with parents' mental and physical health currently not creating problems, there seems to be no imminent need to search out support services or other accommodations for aging parents.

This is now the time to evaluate the home to make it safe and secure for your loved ones, now and in the near future, in anticipation of aging disabilities that may occur. Help and support are available. The nation as a whole is more aware of elderly needs and services and products are becoming available at an outstanding pace.

The Bureau of Labor Statistics states: "Employment of personal and home care aides is projected to grow by 51 percent between 2006 and 2016, which is much faster than the average for all occupations. The expected growth is due, in large part, to the projected rise in the nubbier of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities."

Where do you begin to make sure your elderly family member is safe and managing well in his or her home? Visit them often and at different times of the day and night. Make note of daily activities that appear challenging and where changes might be made to add safety and convenience. Remove rugs that slide, causing a fall, and move furniture with sharp edges. Set the water heater at a lower temperature which will protect older sensitive skin from scalds and burns. Be sure smoke detectors and carbon monoxide detectors are in place.

Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a must to help prevent falls. There are easy to install bars at your local hardware store if you want to do the work yourself. Another item that is good to have is a shower stool or chair.

There are many other programs and sources of information available through your Area Agency on Aging. The national organization can be accessed at their website www.aoa.gov.

Caregiver Burnout

If you are a primary caregiver for a loved one, you are well aware of the daily stress and emotional and physical impact it can have on your health.

Susan learned this first hand when she and her husband, Dave brought his mom home to live with them. Mom suffered from dementia and had to be watched constantly. Susan found that when you become a caregiver, you start by giving up a few things you usually do for yourself to make up for the time needed for care giving. Even though your service is one of love and you are willing to do the sacrifice on behalf of your loved one, you find yourself giving up a lot more as time goes on.

"As a caregiver," Susan laments, "You are often frustrated that you can't do enough for your loved one and so guilt and feelings of inadequacy set in. Couple that with feelings of being unduly burdened, of resentment, of stress and then of more guilt at having those feelings."

She continues, "Now don't get me wrong, I am very glad that I spent those years in care giving. There were many cherished moments with Mom that only I experienced."

In order to enjoy those moments and sustain your care giving momentum, a little respite is essential.

One source of help can be Adult Day Care, which provides respite for the caregiver to have time to themselves and gives the loved one some social and interactive therapy with their peers. Finding an Adult Day Care Services provider takes a little investigating on your part. It is important to know what you are getting and that your loved one is comfortable with his or her new surroundings.

Ask for recommendations from your local Senior Center, Area Agency on Aging or your family physician. The best recommendation is by someone who has used the adult day care service or is familiar with those who run it.

Call the facility and ask them to send you information, including the application, eligibility requirements and payment information. Also ask about the activities, menus, hours of operation and the possibility of transportation to and from the facility.

Once you are comfortable with their program go visit the facility with your loved one and take a tour to insure everyone is on board with the plan. Don't be surprised to find some resistance but keep in mind that although you may be made to feel guilty it's imperative that you take care of yourself so you can continue being a healthy caregiver!

National Health Care Legislation

I have been spending time contacting my representatives in the Senate and House to encourage them to make progress on reforming our health care system. The time has come to stop large insurance companies from raping the American people. While the media covers these outrageous demonstrators who are trying to prevent the country from having a discussion on this very important issue, they fail to report the earnings of United Health Care for the second quarter. I am sure most of you are unaware that they showed a profit of $800,000,000. The CEO of the company is paid millions of dollars while they reduce the number of insured to build up their bottom line. Watch the following report at http://bravenewfilms.org/. Look for the film entitled SICK FOR PROFIT. (If the link does not work copy and paste it into your browser window.)

The truth of the matter is that people don't become aware of how shaky their health insurance is until they try to use it. That's when you realize how vunerable you are. Five years ago I was diagnosed with cancer and wanted to be treated at the Mayo Hospital. I was informed that Mayo Hospital was not within their network and therefore there would be a higher deductible. The original estimate of out of pocket expense was $20,000! We decided after visiting surgeons within the insurance company's network, that none of them measured up to the doctors we dealt with at Mayo. After the surgery and follow up treatment our total out of pocket expense was $45,000.

I urge all of you to learn about your coverage before you need to use it! Also, take the time to call your Senators and Congressional Representatives and insist that they support reform including a public option to compete with the private insurers. You can reach them by calling 800-833-6354, and follow the prompts. I would love to hear your feedback, please e-mail me at TRF649@aol.com.

The Limits To Family Care Givers

The supervision of care or hands-on care from informal care givers is limited to activities that don't require a skilled nursing background. Lifting, bathing,dressing diapering, toileting and helping with walking can be a challenge to family caregivers because the don't have the proper tools or are not trained in this area. Or the children of elderly care recipients may have difficulty dealing with cleaning messy bottoms or bathing their parents. another problem may be handling errant behavior from dementia or depression.

Because of this, some families bring in paid providers to help with lifting, walking, bathing, incontinence, toileting, dressing and supervision. Home care is almost always provided in the home of the recipient or the home of a family member. Home care may under certain circumstances be offered in other settings such as group homes or independent retirement communities.

As a general rule government programs will not pay for long term care unless there is a skilled medical neeed, Thr predominance of care provided in the home is non-medical and therefore government programs will not pay. Government programs will pay for home care that is non-medical under certain conditions. The care-recipient must be low income and have few assets. Although Medicaid and other state programs do not consider the value of the patients home when calculating eligibility.

A New Approach

I recently read an article telling the story of a residential home for Dementia and Alzheimer patients who had become violent, many had been expelled from other homes due to their behavior problems. The facility is named Lakeview Ranch and is in a small rural community called Darwin, Minnesota. The link below will take you to a short film which talks about their approach. I look forward to hearing your thoughts and opinions. http://tinyurl.com/plexo9 .

My Mission

My hope is to be able to help people who find themselves with a need to secure home care services for themselves or a loved one. Many people find themselves in an emergency situation and have little or no knowledge regarding the types of home care services that are available. Most citizens tend to think that Medicare covers home health care and that is partially true. If a doctor orders professional services, IE. skilled nursing care, physical therapy a patient may also receive visits by a home health aide to assist with bathing. Unfortunately these services are intermittent, which means that a nurse may come to access a wound or provide a treatment. The average visit lasts about 45 minutes meaning that the patient will be alone unless other provisions are made.