If we were to ask an older person what his or her most important concerns for aging are, we would probably get a variety of different answers. According to surveys frequently conducted among the elderly, the most likely answers we would receive would include the following three principal concerns or life wishes:
- Remaining independent in the home without intervention from others
- Maintaining good health and receiving adequate health care
- Having enough money for everyday needs and not outliving assets and income
To address these concerns or wishes and maintain the quality of life wanted in the elder years, it simply takes a little pre-planning.
Few people do this kind of planning.
It is human nature not to worry about an event until it happens. We may prepare financially for unexpected financial disasters by covering our homes, automobiles and health with insurance policies.
However, no other life event can be as devastating to an elderly person’s lifestyle, finances and security as needing long term care. It drastically alters or completely eliminates the three principal lifestyle wishes listed above.
The majority of the American public does not plan for this crisis of needing eldercare. The lack of planning also has an adverse effect on the older person’s family, with sacrifices made in time, money, and family lifestyles.
Because of changing demographics and potential changes in government funding, the current generation needs to plan for long term care before the elder years are upon them.
Let us look at some facts.
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The population of the “very old,”–older than age 85–is the fastest growing group in America. This population is at highest risk for needing care. (Statistical abstract of the United States, 2008, population)
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Medical science is preventing early sudden deaths, which means living longer with impaired health and greater risk of needing long term care.
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The Alzheimer’s Association estimates the risk of Alzheimer’s or dementia beyond age 85 to be about 46% of that population.
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It is estimated that 6 out of 10 people will need long term care sometime during their lifetime.
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Children are moving far away from parents or parents move away during retirement making long distance care giving difficult or impossible.
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Government programs–already stretched thin for long term care services–will experience even greater stress on available funds in the future.
One of the important things for planning is how to maintain your lifestyle as you age. You may be healthy enough to stay in your own home with help provided for the following activities of daily living:
maintaining a home,
providing meals,
supervision,
companionship,
transportation and
shopping services.
This type of care at home is non-medical and must be provided free of charge by family, friends, or volunteers or the care must be paid for out-of-pocket by the family.
Government programs, in most cases, will not pay for this kind of care. It is estimated that 80% of all long term care is non medical, with 90% of that care provided in the home. It is most likely that your long term care will begin with home care.
It is wise to plan now how you will pay for care when it is needed. In evaluating your future income you may find it necessary to add some resources such as long term care Insurance to pay for assisted living or nursing home costs. Long term care insurance must be purchased while you are younger and healthy. Failing health, stroke or other aging issues will not allow you to qualify for this insurance.
A reverse mortgage will also help pay for home care if staying in your home is an option.
Consider where you may want to live in your elder years. Many assisted living facilities offer complete care alternatives with a nursing home wing if needed. Senior retirement communities also offer many amenities with some including home care options.
Now is the time to do estate planning. A professional estate planner will give you direction on how best to protect your assets for future needs and for Medicaid planning.
Do your paper work. Now is the time to create your trusts, will, medical directives in a living will and any other documents you want noted for future use. Gather Insurance policies and bank records where they can be found by family members in case you are not able to get them yourself.
We don’t like to think of our elder years in terms of health problems, but a sudden stroke, heart failure or onset of dementia could make it impossible to carry out our own wishes if preparation was not made ahead of time.
The process of long term care planning involves the following four
principles:
- Knowledge and preparation are the keys to success.
- Having funds to pay for care expands the choices for care settings and providers.
- Using professional help relieves stress, reduces conflict, and saves time and money.
- Success is assured through a written plan accepted by all parties involved.
(The above excerpt is quoted from “The 4 Steps of Long Term Care Planning,” National Care Planning Council)
The National Care Planning Council’ s website — www.longtermcarelink.net — provides over 700 pages of information for long term care planning and lists services of professional care providers in estate planning, long term care insurance, reverse mortgage, home care and many other important long term care services.
The National Care Planning Council’ s book, “The 4 Steps of Long Term Care Planning,” provides information on what Medicaid and Medicare will cover as well as an overview of professional long term care service providers and how their services can help you create and execute your long term care plan. A check list of what to do to create a plan and forms for creating necessary paperwork are also included in the book.
(ARA) – The aging population in the country is growing by the minute. According to the U.S. Census Bureau, by 2030 the number of individuals ages 65 and up is expected to be twice as large as in 2000 — growing to 71.5 million — and representing nearly 20 percent of the population.
With these burgeoning numbers, it’s becoming increasingly important to create a safe home to accommodate everyone’s wants and needs, and baby boomers are taking notice. According to a major home improvement center study, 60 percent of boomers plan to stay in their existing homes for some time. Remodeling and home improvement rank high on their to-do lists. Following are projects they can tackle themselves to ensure they are home to stay:
Safe, secure and stylish in the bath
As one of the most often used rooms in the home, the bathroom is a great place to undertake “home to stay” tasks. From projects such as custom closet configurations and adjusting mirror and toilet heights to installing roll-under sinks and angled mirrors, many product options exist for baby boomers to make their bathrooms safe yet stylish.
To help prevent slipping, tub grips are essential in lending a stable, helping hand getting in and out of the tub. The latest tub grip product designs feature an easy-locking lever to ensure a tight fit to most tubs without harming the tub surface. They offer easy, no-tool installation and removal in seconds. Shower chairs are another safe showering option for bathers that can be easily installed or removed as needed.
Today’s consumer not only needs secure safety products for the home, but wants ones that blend and complement a variety of decors. Grab bars are a great addition to help assist with movement. SecureMount Grab Bars from Home Care by Moen are an ideal choice since they feature a unique anchor installation system that allows homeowners the ability to install quickly and easily anywhere on the wall — without the need for a stud — for the ultimate in safety and peace of mind. Plus, they are available in a variety of styles and finishes to beautifully coordinate with the rest of the bathroom.
New home standards
In addition to the bath, other areas of the home — such as the kitchen — rank high on the list for projects and safety updates that are quickly becoming new home standards for baby boomers. Ranging in cost, improvements such as expanding doorways and lowering countertops/sink areas help not only wheelchair-bound individuals, but also parents carrying groceries or pushing strollers. Installing a pulldown kitchen faucet helps access hard-to-reach areas of the sink and also aids in everyday tasks such as watering plants or filling large pots and pans.
Consolidating essential appliances and living areas in one space in the home is another trend for boomers. Adding a first floor bathroom, installing a first floor water turnoff and washer or dryer allow easy access for any family member.
By making these improvements, you’ll create a safe and stylish home — one you’ll want to stay in and enjoy for years to come.
For additional tips and home improvement projects for baby boomers, visit ageinplace.com. For more information about stylish bath safety products from Home Care by Moen, visit homecare.moen.com or call (800) 882-0116.
Courtesy of ARAcontent
(ARA) – Later in life or when faced with a serious illness, we face a variety of health issues and might not be able to care for ourselves like we want. Making an advance care plan can ease worries for you and your family about what might happen to you if you are unable to make decisions about your own care.
An advance care plan is a written document that helps you make sure your care is specific to reflect your personal likes and dislikes and health needs, as well as meet your social, cultural and religious needs. Getting answers to your questions and letting people know what you want at the end of your life can help you feel more in control and give you peace of mind as you go about living your life.
“An advance care plan is a good idea for all adults, regardless of their medical history. Discussing these issues can be difficult – even impossible if a crisis is ongoing. The goal is to make it easier for the patient and the family if the situation does happen,” says Dr. Clyde Yancy, chair of the education committee at the Heart Failure Society of America, a nonprofit educational and research organization dedicated to improving the quality and duration of life for patients with heart failure and preventing the condition for those at risk.
Many chronic diseases, including but not limited to heart failure, can eventually use up all reasonable medical approaches. Planning ahead is important. An advance care plan often includes an advance care directive, a do-not-resuscitate order, a living will, a health care power of attorney and a financial plan.
Advance care directive
This document will provide clear directions regarding your medical treatment and can include a living will, a durable health care power of attorney and a statement about organ donation.
Do-not-resuscitate order
This part of the plan tells doctors, nurses and other rescue personnel what they should or should not do when a person stops breathing or when their heart stops beating or is beating so irregularly it threatens life. The order can include instructions on whether to use different types of methods to revive a person.
Living will
A living will is usually used during a terminal illness when a person is unable to tell someone what they want to do. It is a legal document that lets a person who is unable to participate in decisions about their medical care express their wishes about life-sustaining treatment.
Health care power of attorney
A health care power of attorney lets someone make all legally binding health care decisions for you, including the decision to refuse life-sustaining treatment if you are unable to make the decision for yourself.
Financial plan
Health care can be very expensive, especially when treating chronic illnesses. A financial plan is created to help families deal with issues such as paying for medicines, doctor visits and hospital stays.
“Telling those close to you what you want helps them convey your wishes to those providing care for you – it should be comforting to know that the care is provided for you in a way that best meets your wishes,” says Yancy. “Even if you do not create a written advance care plan, these discussions with your health care providers, family and other caretakers are important.”
To learn more about advance care planning visit the Heart Failure Society of America at www.abouthf.org.
Courtesy of ARAcontent
The following was written by my good friend Marla Beck who owns AndelCare, a sister home care company in Bellevue, WA:
Marla’s Musings
Life is definitely full of surprises and never boring. Just when I thought everything was going along smoothly – happily married, diligently working on my business – I received a big shock when having a routine exam with my dermatologist, Dr. Ochs. She removed two moles that looked darker and sent them to the lab. Less than a week later, Dr. Ochs called to say I had stage 2 Melanoma and could I make a 4 pm appointment. I had the surgery the same day I received the news – at least I didn’t have long to think about it and my surgeon Dr. Schmidek was wonderful. I just have a huge hole in my thigh (have pictures to prove it on my Facebook page www.facebook.com/marla.beck) that will take a while to heal. Good news, after my skin cancer surgery all my tests came back negative so that means all the cancer cells were taken out by the surgeon and I’m clear.
Please pay attention to your skin and go have your dermatologist do a whole body skin check at least once a year. Be pro-active in making healthy choices because good health is the most important gift for yourself and the people you love and care for.
Advantages and Disadvantages of Prepaid Plans
One way to plan in advance for the end of one’s life is to sign a formal contract called a “preneed funeral plan.” With this plan, money to pay for a funeral and/or burial is held in a trust, in an escrow account or paid through an insurance policy on the life of the person desiring the plan. Parts of or all of the funeral service and burial are designed in advance and pre-funded in advance and the family has little to do but show up.
This type of planning has become very popular in recent years. A survey conducted by the AARP in 1999, found that two out of five people over age 50 had been approached to pre-purchase funerals and burial goods and services. An AARP survey in 1998 indicates that 32% of all Americans over age 50, roughly 21 million people, have prepaid some or all of their funeral and or burial expenses (but not necessarily through a formal preneed plan). Breaking that down; about 25% of the over age 50 population have prepaid for their burials (cemetery plot, mausoleum or niche), 18% have prepaid for headstones, urns, caskets , grave liners or vaults, opening and closing of graves and so on and 13% have prepaid for goods or services from a funeral home or funeral director. The same survey indicates that over $25 billion is being held in preneed trust funds. Roughly another $25 billion is waiting to be paid out in life insurance benefits. Prepaid or preneed funerals and burials are big business.
Funerals and burials funded privately by the family, or paid from an individual life insurance policy and arranged informally through a funeral home or funeral director are generally not subject to state regulation. Any formal arrangement through a second party or involving a contract is subject to regulation in all states. Each state has adopted different rules as to who can sell these plans, what the plans can provide, what contract provisions must be, how the plan is to be funded and what recourse purchasers might have in the event of fraud or default. All states call these regulated plans “preneed” funeral and burial arrangements.
Here are some advantages as to why one would want to buy a preneed plan for funeral and burial services and goods.
- It provides peace of mind knowing these arrangements have been made in advance.
- It avoids the burden on family members to make decisions when they are most vulnerable to manipulation.
- It allows one to virtually control from the grave by determining in advance the funeral products, funeral services, burial products and burial services that one would prefer having for final arrangements.
- It helps the family to avoid taking loans, arranging finance plans, raiding savings or selling assets to pay for a funeral and burial.
- It guarantees (for many contracts) that if products and services currently purchased are not available in the future, equivalent substitutes will be provided at no additional cost.
- It locks in guaranteed prices (available with some contracts) forever.
- It allows for inflation in future costs (for those contracts that do not guarantee prices) by investing money in an interest-bearing account or buying life insurance that increases in value over time.
- Depending on the contract, it may allow for transfer to another funeral home or for partial or full refund.
Unfortunately, there are also problems with prepaid, preplanned final arrangements.
- With some trust fund and insurance funding options there may be no refund if someone wants to cancel the plan in the future.
- If a purchaser moves to another state there may be no transfer options or there may be different rules governing the funding option.
- In some contracts, interest earnings on investments resulting in excess money not needed for the plan may be retained by the funeral home or funeral director.
- On installment plans interest may be charged but not credited to the account.
- In certain insurance funded contracts, the ownership or death benefit may be irrevocably assigned to the contract holder (funeral home), preventing the purchaser from enjoying ownership rights in the policy.
- In certain insurance funded contracts, a growth in the death benefit over time that exceeds the cost of the preneed plan services and goods may be pocketed by the contract holder (funeral home) instead of being refunded.
- If the contract provider goes out of business or fails to secure 100% of the funds for future payment, there may be no recourse to get all of the money back that was put in.
- If certain services or goods that were purchased initially are not available in the future, but more expensive versions might be, the family may be forced to pay extra for those items.
- In certain insurance funded plans, if the insured dies too soon, there may have been a waiting period in which few or no benefits are paid at death, thus forcing the family to pay out of pocket for the funeral.
- Certain unscrupulous providers may have failed to provide an itemized list of services and goods or failed to identify properly, specific services and goods, thus allowing the provider in the future to substitute less expensive items or to leave out services and goods that were originally anticipated in the agreement.
What Services and Goods Can Be Prepaid?
All states allow for prepaid plans for funeral services and merchandise. This would include such things as picking up the body, embalming and restoration, rooms or chapel for viewing and funeral services, casket, vault or grave liner, transportation, permits, death certificates, obituaries and so forth. Almost all states allow for prepaid burial services and merchandise as well. Only about six states do not allow it. Burial services and merchandise might include opening and closing the grave, grave markers, vaults or grave liners, mausoleums or niches. Cemetery plots are excluded from prepaid plans in all states.
The AARP has excellent information for consumers on planning for funerals. Quoting from the AARP:
“Most states have a licensing board that regulates the funeral industry. You may contact the board in your state for information or help. If you want additional information about making funeral arrangements and the options available, you may want to contact interested business, professional and consumer groups.”
To find a planner in your area you may also contact the National Care Planning Council at inquiry@longtermcarelink.net or call 800-989-8137
In last month’s column, I focused on the subject of “How to Deal with Depression,” and primarily addressed the warning signs and causes of this malaise as well as suggested some tips for overcoming depression. We established that, left alone, depression not only prevents older adults from enjoying life, it also takes a heavy toll on their health and their family.
When we see a loved one or friend suffering in a state of depression, our heart breaks for them and we desperately desire to offer help. However, unless we’re prepared and understand the weight associated with the negativity of depression, we may get pulled down with them.
In today’s column, I want to focus on the important consideration of taking care of you while supporting a loved one struggling with depression.
There is no doubt your support and encouragement can play an important role in a loved one’s recovery from depression. Yet taking care of yourself is equally important. The burden of depression will wear you down if you don’t tend to your own needs — and if it does, you won’t be in a position to help your friend or family member.
According to Helpguide.org, “Depression is a serious, but treatable disorder that affects millions of people, from young to old and from all walks of life. Depression gets in the way of everyday functioning and causes tremendous pain. And it doesn’t just hurt those suffering from it — it impacts everyone around them.”
If someone you love has a mood disorder, you may be struggling with any number of difficult emotions: helplessness, frustration, anger, fear, guilt, sadness. However, all of these feelings are normal. Dealing with a friend or family member’s depression, particularly an older adult, is difficult. But if you aren’t careful, it can become overwhelming.
That said, you can make a difference in a loved one’s depression by learning about the problem, encouraging treatment and offering support. In fact, one of the most important things you can do to help is give your unconditional love and support. Finally, you can help by looking after your own emotional health. Taking care of yourself when someone close to you is depressed is not an act of selfishness — it’s a necessity. Being emotionally strong allows you to continue to love and care for the other person.
There’s a natural impulse to want to “fix” the problems of people we love, but you can’t control a loved one’s depression. You can, however, control how well you take care of yourself. And it’s equally as important for you to stay healthy as it is for the depressed person to get treatment.
The following basic guidelines will help you keep up your strength as you support your loved one through depression treatment and recovery:
- Speak up for yourself. You may be hesitant to speak out when the depressed person in your life upsets you or lets you down. However, communicating will actually help the relationship in the long run. If you’re suffering in silence and letting resentment build, your loved one will pick up on these negative emotions and feel even worse.
- Set boundaries. Of course you want to help, but you can only do so much. To avoid burnout and resentment, set clear limits on what you are willing and able to do.
- Stay on track with your own life. While some changes in your daily routine may be unavoidable while caring for a loved one, do your best to keep appointments and plans with friends.
- Seek support. You are not betraying your depressed loved one by turning to others for support. Joining a support group, talking to a counselor or clergyman, or confiding in a trusted friend will help you get through this tough time.
Remember the advice of airline flight attendants: “Put on your own oxygen mask before you assist anyone else.” In other words, make sure your own health and relationships are solid before you try to help a depressed person. When you’re on solid ground, you’ll be in a place to help your loved one.
Carl R. Johnson
Certified Senior Advisor (CSA)®
Community Relations Director
Abiding HomeCare
Silverdale, WA
Let me begin with the assertion that depression is not a normal or necessary part of aging. For most seniors, especially for those who are active–physically, mentally, and socially–depression is likely not an issue. But for those who do struggle with bouts of depression, there is probably nothing more debilitating and corrosive to the human spirit. Left alone, depression not only prevents older adults from enjoying life like they could, it also takes a heavy toll on their health and their family.
In today’s column I want to help identify the causes and risk factors that contribute to depression, as well as offer some tips for overcoming this malaise. In next month’s column, we’ll focus on the equally important consideration of taking care of you, while supporting a loved one struggling with depression.
If you have depression, or know someone who does, you and they are not alone. According to the National Institutes of Health, of the 35 million Americans age 65 or older, “about 2 million suffer from full-blown depression” … and another “5 million suffer from less severe forms of the illness.”
Unfortunately, while depression in the elderly is a common problem, only a small percentage gets the help they need. This may be due to an assumption that the senior has good reason to be “down,” or that depression is simply a part of the aging process. Sadly, older adults are often isolated, with few around to notice their distress. And even physicians are more likely to ignore depression in older patients, concentrating instead on physical complaints. In the end, many depressed seniors are simply reluctant to talk about their feelings or ask for help. And, of course, the consequences of this oversight are high.
As you might imagine, untreated depression poses serious risks for older adults, including illness, alcohol and prescription drug abuse, a higher mortality rate, and even suicide. So it’s important to watch for the risk factors and warning signs, and seek professional help when you recognize it.
Risk Factors & Warning Signs
According to HELPGUIDE.org: “Many elderly adults face significant life changes and stressors that put them at risk for depression. Those at the highest risk include older adults with a personal or family history of depression, failing health, substance abuse problems, or inadequate social support.”
You need to be especially aware of the following conditions: 1) Loneliness and isolation due to living alone, illness, decreased mobility, or a dwindling social circle of friends. 2) Reduced sense of purpose usually associated with a loss of identity due to retirement or physical limitations on activities. 3) Health problems manifesting chronic or severe pain; cognitive decline; or disfiguring surgery or illness. 4) Medications that can trigger or exacerbate depression. 5) Fears … of death or dying, as well as financial and health problems. 6) Recent bereavement due to the death of a spouse or partner, a loved one, a friend, or even a pet.
By the way … although a grieving person may experience a number of depressive symptoms such as frequent crying and profound sadness, grief is a natural and healthy response to bereavement. There is a difference, however, between a normal grief reaction and one that is disabling or unrelenting. While there’s no set timetable for grieving, if it doesn’t let up over time – it may be depression.
So what are the “warning signs”? Although the following characteristics may not individually be an indication of depression, when you see several of these manifesting themselves, be alert to the danger: Sadness … Fatigue … Abandoning or losing interest in hobbies or other pleasurable pastimes … Social withdrawal and isolation … Weight loss or loss of appetite … Sleep disturbances (difficulty falling asleep or staying asleep, oversleeping, or daytime sleepiness) … Loss of self-worth … Increased use of alcohol or other drugs … Fixation on death or suicidal thoughts … Anxiety or irritability.
Tips for Overcoming Depression
If you’re depressed, you may not want to do anything or see anybody. But isolation and inactivity only make depression worse. The more active you are–physically, mentally, and socially–the better you’ll feel. In a real sense, combating and preventing depression requires choices, and a recognition that the ball is in your court. So here’s what you can do: 1) Get out into the world … try not to stay cooped up at home all day. 2) Connect with others … limit the time you’re alone. 3) Volunteer your time … helping others is one of the best ways to feel better. 4) Take care of a pet … get a pet to keep you company. 5) Maintain a healthy diet … avoid eating too much sugar and junk food. 6) Exercise … even if you’re ill, frail, or disabled, there are many safe exercises you can do to build your strength and boost your mood.
Now … let’s go and enjoy life!
Carl R. Johnson
Certified Senior Advisor (CSA)®
Community Relations Director
Abiding HomeCare
Silverdale, WA
