Eldercare In An Age of Scarcity:Who Will Care? Who Will Pay?

For Faith Organizations:Elder Care Support Program Can Help your Parishioners

2011-09-23T13:41:00.000-04:00

Elder Life Planning for Faith Based Communities: An Ecumenical, Nationwide: Intervention Model for Congregations and Church Organizations of All Faiths
Conscientious professional and lay religious leaders have increasingly found themselves largely unprepared to address the growing needs of older persons in their congregations and their families.

Communities of faith are, however, in excellent positions to help families plan for the care of their older members. Many devoted members of their congregations are more likely to rely on their own faith and on advice from their clergy in addressing family problems than they are to rely on publicly funded social services or other community agencies.

Elder Life Planning for Faith Based Communities is a well developed and tested service using an ecumenical approach to improve the well-being of older persons, reducing the often stress related complications that family caregivers must confront, including the increasingly complex and expensive system of eldercare services that has evolved in the U.S. in recent years.
Elder Life Planning can help your parishioners in the following ways:

Reduce caregiver stress
Provide live seminars at the parish level on the topic of “Your Aging Parents”
Internet based education and “coaching”
Make sense of the legal and financial aspects of long term care planning

Please see the Power Point presentation for more detailed information on how our program can help you serve your elder population more effectively. http://youragingparents.net/Faithbasedelpo.pdf

Services include:
Resources that emphasize the importance of planning ahead for the day when they or a loved one might need care.
The program’s components, include; access to a toll free, professionally staffed, caregiver support center that is available 7 days a week. This service also provides multi-lingual support in more than 30 languages.
For more information contact Bob O'Toole at Informed Eldercare Decisions, Inc.
Toll Free: 1-800-375-0595
E-mail: Bob@elderlifeplanning.com

Televangelist Says: "Divorce OK If Spouse Has Alzheimer’s Disease"

2011-09-23T13:03:00.036-04:00

It looks like televangelist Pat Robertson has put his foot in mouth yet again and Twitter is disgusted. On Robertson’s nationally syndicated show “The 700 Club,” he said divorce was OK so long as one spouse has Alzheimer’s disease.

Robertson’s remarks came in response to a question asked by a man named Andreas who has a friend whose wife suffers from the disease.

“That person is gone. They are gone" The famous preacher said." ..I know it sounds cruel but if he’s going to do something he should divorce her and start all over again “Till death do us part. This is a kind of death. So that’s what he’s saying.”
On Twitter, thousands of people, including preachers, have addressed Robertson’s comment with disappointment and disdain. Just in the last couple of hours, Robertson has been mentioned more than 3,000 times, according to statistics from Topsy, a social medias search engine.

“Pat Robertson's latest craziness isn't just an embarrassment,” tweeted Russel Moore (@drmoore), who claims to be a baptist preacher from Louisville. “It's a cruel repudiation of Christianity itself.”

“Pat Robertson said divorcing a spouse with Alzheimer's is OK. It's also OK to ignore soulless old men who are asshats,” tweeted Rex Huppke (@rexhuppke).
“#Alzheimer's is a heartbreaking disease for patients & their fam. How could ANYONE suggest abandoning your loved one bc they are ill?” tweeted Emily Carter(@emilycarter).

The reaction from many evangelical leaders, who see lifelong, traditional marriage as the cornerstone of morality and society, was harsh and disbelieving.

“This is more than an embarrassment,” Russell D. Moore, dean of the School of Theology at Southern Baptist Theological Seminary in Louisville, Ky., wrote in a blog post on Thursday. “This is more than cruelty. This is a repudiation of the gospel of Jesus Christ.”
But Beth Kallmyer, senior director of constituent services at the Alzheimer’s Association in Chicago, declined to question Mr. Robertson’s remarks.

“This is a challenging, devastating and eventually fatal illness, and it affects everybody differently,” Ms. Kallmyer said. “The most important thing is that families get help.”
In the association’s experience, she said, it is rare for people to get divorced because of Alzheimer’s. But Alzheimer’s can go on for years or decades, progressively worsening.
“The decisions people make are personal,” Ms. Kallmyer said.

Dr. Amanda G. Smith, medical director of the Alzheimer’s Institute of the University of South Florida Health, in Tampa, said of Mr. Robertson’s remarks, “I think he was trying to give someone the freedom to move on, but he only took account of the caregiver without taking account of the patient.”

“Even if someone doesn’t recognize a spouse as specifically their spouse, there is often a familiarity with that person and a feeling of comfort, especially if they have been married for decades,” Dr. Smith said.

Dr. James E. Galvin, a neurologist who runs a dementia clinic at New York University Langone Medical Center, said it was wrong to say that people with Alzheimer’s were “gone,” or to call its late stages “a kind of death.”

“While it’s true that in terminal phases, patients may not be fully aware of what’s going on, they tend to recognize the people who are closest to them,” Dr. Galvin said.
With good care, people may live 15 to 20 years with the disease, most of that time at home, Dr. Galvin said. If they eventually move to a nursing home and seem unaware of what is going on around them, he said, then spouses face “an individualized decision”

Communities of faith can help families plan and manage the care of their older members. Many devoted members of their congregations are more likely to rely on their own faith and on advice from their clergy in addressing family problems than they are to rely on publicly funded social services or other community agencies.

Elder Life Planning for Faith Based Communities uses an ecumenical approach to improve the well-being of older persons, reducing the often stress related complications that family caregivers must confront.

http://www.americanprogress.org/issues/2011/04/faith_poverty.html

http://www.scoop.it/t/how-faith-based-communities-can-respond-to-eldercare-needs-of-their-congregations

http://www.programsforelderly.com/caregiver-elder-life-planning-faith-congregations.php

Find out more at http://youragingparents.com

Eldercare Specialist Says Working Caregivers Face Painful Choices

2011-09-22T18:42:00.000-04:00

Kirsten Hartman a Certified Geriatric Care Manager, is the owner of Seniors in Transition, LLC, in Fort Collins, Colorado. In her work with family caregivers, Hartman frequently sees the painful choices that caregivers, typically middle aged sons and daughters of parents who are now octagenarians or older, must struggle with on a daily basis.

In a post on the business networking site LinkedIn, Hartman called attention to an article recently published in The New York Times entitled, "Easing the stress of daily caregiving,"

"The article led me to wonder what are employers in Fort Collins and surrounding Larimer County doing to support their employees who are family caregivers?"

In the Times piece, author Eilene Zimmerman addresses a reader's concern about the stress she feels while juggling the tasks of working full time with caring for an aging loved one. According to Denise M. Brown, founder of Caregiving.com, "Caregivers often feel they have one choice: quit their jobs and become full-time caregivers or keep working but do an inadequate job of meeting the needs of their ailing family member."

Clearly, if employees feel distracted while at work, or worse yet, miss work to care for a loved one, the workplace can suffer. An estimated 25.5 million Americans are balancing work, caregiving and their own family life according to AARP. "In Larimer County", says Hartman, "it is estimated that by 2015, the number of adults older than age 60 will expand to 63,240, or 19 percent of the total county population. At the same time, in 2015, the number of people older than 75 will be 18,349. These statistics are taken from the Larimer County Office on Aging's "Four-Year Planning & Service Area Aging Plan," reported in July, 2011.

In her post, Hartman raises several questions about the impact on the pressures of balancing work and caregiving on both employers and employees. "Of the 18,349 seniors aged 75 and older who will be living in Larimer County in 2015, how many of them will have family members providing some kind of caregiving assistance?" "How many of these caregivers are also part of the workforce?" How many will use their own sick days to escort a parent to a doctor appointment or leave work early in order to meet with a financial planner, realtor or an attorney on their parents' behalf?"

"If we assume that a significant percentage of these family caregivers are working and struggling - and that there is a residual effect on the workplace - it is reasonable to suggest that employers would benefit by supporting their employees during these times." Hartman writes.

Some options for employers to consider that could reduce working caregivers stress and even improve productivity in the workplace are: flexible work schedules, telecommuting and job sharing.

"If employers are willing to think outside the box and open a dialog with their employees about creating a win-win work environment that supports work-life balance, employees will likely be less stressed, more focused while at work, less fearful of losing their jobs, and employers will benefit by having a more consistent, productive staff."

Kirsten Hartman, Certified Geriatric Care Manager, is the owner of Seniors in Transition, LLC. www.seniorsintrans.com.

Primary Care Doctors Can Diagnose and Treat up to 90 Percent of Patient Problems Without Needing a Specialist

2011-08-29T17:13:00.001-04:00

The secret to better patient care is time by Rick Donahue, MD
http://www.kevinmd.com/blog/2011/08/secret-patient-care-time.html
If you want a clear explanation of what's wrong with the bloated, inefficient health system that some politicians keep insisting is the "best health care system in the world"

In fact the US has the 37th best health care system in the world, according to data from the World Health Organization (WHO). We do, however rank ahead of Slovenia, Cuba and Brunei, who rank 38,39 and 40 respectively.

The top ten are France, Italy, San Marino, Andorra, Malta, SIngapore, Spain, Oman, Austria, and Japan.
11-20 are Norway, Portugal, Monaco, Greece, Iceland, Luxembourg, Netherlands, United Kingdom, Ireland, and Switzerland.
21-30 are Belgium, Columbia, Sweden, Cyprus, Germany, Saudi Arabia, United Arab Emirates, Israel, Morocco, and Canada.
31-40 are Finland, Australia, Chile, Denmark, Dominica, Costa Rica, United States of America, Slovenia, Cuba and Brunei.

Dr. Rick Donahue, a clinical instructor at Harvard Medical School with 20 years of experience delivering complete primary care,writing in the medical blog edited by Dr Kevin Pho, whose blog is regarded as one of the most highly informative on the internet.(for about Dr. Pho see end of this post) Has written an article that I urge our visitors to read in it's entirety. Here is a brief excerpt:

"Lets face it — the system of primary care medicine in the United States is broken. Even in Boston, the mecca of medicine, patients struggle hard to find an accessible doctor. And when they finally land an appointment, their well-intentioned internist, pediatrician or family physician often seems overworked, rushing from patient to patient, with little time to really listen to details."
"As a primary care family physician for 20 years, I hear my colleagues saying, “I went into medicine to put the whole clinical picture together. I really care and want to know my patient — but the system doesn’t give me the time to do it!”

"The basic issue is time. People really are beautifully complex, more than the sum of their organs. So patients don’t have isolated problems, but present to their family doctor with two or three (maybe as many as six!) problems that are often interconnected. They’ve stored up all these issues for their one 15- to 20-minute doctor’s appointment, which took a month to get. The patient feels rushed, the doctor feels rushed, and telling details are often missed."

"...Most diagnoses, even rare ones, can be made by asking open-ended questions and having the focus to listen very carefully to the finest details of the patient’s story...
"A dedicated primary care doctor is trained to diagnose and treat up to 90 percent of patient problems without needing a specialist. But in today’s health care environment, with no time to get a detailed history, the trend is to quickly refer patients on to a specialist..."

"By referring common health conditions too readily to specialists, both the general doctor and the specialist can diminish their skills. The generalist becomes less expert at caring for common problems, and the specialist, flooded by common issues that could have been addressed by a primary care physician, has less time to devote to the more complicated, rare conditions he/she are specifically trained to diagnose and treat. Ultimately, it costs the patient (and the health care system) more time and money."

"From my experience, I believe that urging primary care doctors to spend more time with patients can not only provide better care across the board, but save patients’ time and the health care system money. The primary care doctor is uniquely positioned to put together a patient’s whole health picture by connecting the physical condition with the life stressors that often precipitate disease in the first place. Close follow-up, monitoring for changing symptoms, can make earlier diagnoses possible and help prevent treatment side effects."

Founded by Kevin Pho, MD, KevinMD.com is the web’s leading destination for provocative physician commentary on breaking medical news. The Wall Street Journal calls KevinMD.com a “punchy, prolific blog that chronicles America’s often dysfunctional health care system through the prism of a primary care provider,” while others have noted that “a lively comment stream on one of Kevin Pho’s posts provides more insight on the day-to-day realities of health care than any piece of journalism can ever hope to impart.”
http://www.kevinmd.com/blog/2011/08/secret-patient-care-time.html

Prominent Americans Afflicted With Alzheimer's

2011-08-25T11:01:00.001-04:00

Glen Campbell, one of America's outstanding popular singers, a legendary guitar player, and a member of the Country Music Hall of Fame, announced this week that he's been suffering from symptoms of Alzheimer's disease. Despite his affliction, Campbell, 75, is planning one final tour next year to pronote his recently completed album "Ghost on the Canvas"

His wife is afraid he's slipping from the early stage to the middle stage of the disease, and there is no predicting how long he will be able to perform. The album and tour dates are the family's way of helping him stay anchored in the present.

Another Hall of Famer, Pat Summitt, the winningest basketball coach in history plans to coach the Tennessee women's basketball team "as long as the good Lord is willing," despite recently being diagnosed with early-onset dementia.

The 59-year-old Summitt told the newspaper she had been feeling erratic earlier this year, and plans to rely on medication and mental exercises to manage the progressive condition that could lead to Alzheimer's, which her grandmother had.
In a statement from Summitt released by the university Tuesday, the Hall of Fame coach said she visited with doctors at the Mayo Clinic in Rochester, Minn., after the end of the 2010-11 basketball season and was diagnosed with the condition during the summer.
"I plan to continue to be your coach," Summitt said. "Obviously, I realize I may have some limitations with this condition since there will be some good days and some bad days."

Early-onset Alzheimer's is an uncommon form of dementia that strikes people younger than age 65. Glenn Smith, Ph.D., a neuropsychologist at Mayo Clinic, Rochester, Minn., answers questions about this condition.

How common is early-onset Alzheimer's?

Of all the people who have Alzheimer's disease, only about 5 percent develop symptoms before age 65. So if 4 million Americans have Alzheimer's, at least 200,000 people have the early-onset form of the disease. Early-onset Alzheimer's has been known to develop between ages 30 and 40, but that's very uncommon. It's more common to see someone in his or her 50s who has the disease.

Glenn Smith, Ph.D.

As America Ages Decisions Will Have to be Made That Won’t Make Anyone Feel Happy

2011-08-25T10:35:00.000-04:00

Dr. Mikol Davis is a Geriatric Pschologist in the San Francisco Bay area and a founder of Agingparents .com (See more information about Dr. Davis at the end of this post.)

Dr. Davis posted a thought proving message at his LinkedIn Profile about the dilemma faced by adult children who want the best for their aging parents, and the aging parents who want the best for their children and grandchildren. He describes this dilemma as one in which there are "No Win Decisions"

"As the older generation continues to get older, and as younger generations continue to get squeezed in all kinds of ways, decisions will have to be made that won’t make anyone feel happy. Older people will find that their children simply cannot afford to take care of them. Assisted Living facilities or nursing homes will become the default answer for a lot of families, and that’s an extremely painful decision for all involved. All people in this country are being forced to choose priorities that are impossible. Do you want to spend your money and time on your children or on your parents? Who needs you the most? Should you go to work or visit your parents or stay home with the kids?
The discomfort that everyone is facing in our culture is unfortunate and immensely sad."

"We need to talk about this Dr. Mikol adds firmly believe that life doesn’t have to be this way. There has to be another way. There has to be a way to let people stay in their homes yet also get the care they need. There has to be a way to provide for the older generation while the younger generation grows. There has to be a way to afford both food and medicine."

Dr. Mikol Davis is a family conflict specialist and an elder care psychologist with 35 years of experience as a mental health care provider. He has a special interest in aging issues, particularly assessing elders' capacity for making decisions. He has a particular expertise in depression and anxiety. He is a mediator of elder and family conflicts. Together with his wife, nurse-attorney Carolyn Rosenblatt, he is a founder of AgingParents.com, which provides services and resources to those who are caring for aging loved ones

Update" Alheimer's Disease: A Fresh and Enlightening Viewpoint from the Patient's Perspective

2011-08-08T10:44:00.002-04:00

I have published the highly informative commentary of Norm Mac (AKA "Norms") on a few occassions on this blog and think it's time for an update.

What makes Norms commentary about Alzheimer's Disease so compelling is the fact that 4 years ago he was diagnosed with the disease. I've worked with or on behalf of those affected by this disease .I find reading or listening to Norm's commentary on his personal experience with Alheimer's Disease provides a fresh and enlightening viewpoint, no matter how much you think you might know about AD.

Norm Mac 5:09am Aug 7
Four Years Ago
"How times passes, almost four years I was diagnosed with Alzheimer’s Type dementia. The first two years are just a hazy memory and most of what I know about it, is what Elaine “My Angel” has told me, but even though this may seem a strange thing to say, the last two years have been incredible on many fronts. The face of Dementia has changed and the awareness of this awful disease has been heightened to a fantastic level as never before.

The last two years have been incredible but unfortunately this doesn’t disguise the fact that I have a “Terminal” illness, and please make no mistake, it is “Terminal” until a cure is found and every day I have to look my family in the eyes whilst knowing I might be around for as long s I thought I would be or for as long as they want me to. But please don’t forget, I know they must think the same and when I do have thoughts like this, it’s like a knife through the heart.
I have been asked so many times “What’s the worst thing about having Dementia? My Answer is always the same “It’s the thought of my family being so upset at knowing this is happening to me. I have spent all my life shielding them from things like this, I have given my all to make sure they are safe and wouldn’t do anything in the world to upset them. It’s the sheer helplessness of knowing I have this awful disease and having none, or very little control over it. I want to take away my families pain and sorrow, I want to rid their eyes of all the upset I see in them as I look at them, but most of all I want to be there to see them all grow up into their own special kind of person that we have taught, nurtured and helped for so many years."

"Will this happen? Will I beat this awful disease and see my Grandaughters walk down the Aisle on their happiest days of their lives? Will I ever see any of my grandsons graduating?"
"Who Knows!"

"But every time I see them smile, or hear them laugh. Every time I get a peck on the cheek or a great big HUG! It gives me strength from within, a strength I never knew I had, and a ZEST for life that drives me on to the next awareness raising project. I could not finish this blog without mentioning the sheer enormity of support I also get from you, all my dear friends, every message of support from you guys is like a breath of fresh air to my lungs that keeps me breathing every day, for that I am eternally grateful."

All my love and respect, Norrms and family xxxxxxx

I encourage everyone who reads this blog to see and hear Norms speak in a series of videoa avialable on YouTube.
http://www.youtube.com/watch?v=0sHbkdup3Z0&feature=related

Bob OToole
Editor
You can contact me at bob@elderlifeplanning.com

What the Debt Deal Will Mean for Long-Term Care Services

2011-08-03T14:57:00.000-04:00

On several occasions we have highlighted the reporting of Howard Gleckman, who is one of the most insightful commentators on the continuously changing "saga" and the patchwork madness that passes as the U.S version of a long-term care services system for elders.

Yesterday (August 2nd, 2011) Gleckman reported on what he sees as the impact of the recent budget deal in Washington on those who rely on programs like Medicare and Medicaid.

At first glance, Gleckman says it looks like Medicaid and other key government programs for the frail elderly avoided a major hit in the debt limit agreement reached by Congress today. "But in truth all of these programs remain in severe jeopardy".

"While we won’t know exactly what those cuts will be until sometime next fall, there is a very good chance that funding for important non-Medicaid assistance will be reduced. Programs such as Meals on Wheels, transportation, housing subsidies, and information and referral services—all key to the support many seniors need to age in place—will be cut. Many were trimmed in the budget passed by Congress last April, and they face deeper reductions this year. And that could just be the beginning. While the deficit agreement does not force spending decisions on future congresses, it does point the way towards sharper future cuts in these critical safety net programs."

http://howardgleckman.com/blog/?p=281

Warning From FTC: "Use Free Internet Eldercare Services With Caution"

2011-08-02T12:54:00.000-04:00

"The alternative to free referral services is to hire a brick-and-mortar geriatric care management agency."

In an earlier post to this blog (DATE) we made our readers aware of the excellent job of investigative journalism published by The Seattle Post exposing the practices of a company called "A Place for Mom", one of the largest providers of so called "Free Eldercare Information and Placement Services" in the U.S."

Now comes an excellent article in the July 28th edition of Kaiser Health News, by David Spiegel, an Attorney for the Federal Trade Commission.who focuses on consumer protection issues affecting seniors.

Spiegel highlights some of the tactics these "free eldercare services" use to lure unsuspecting family caregivers when they are at their most vulnerable. "They have enticing names that ...that use words like "mom," "help" and "care." Spiegel reports. "They advertise expertise in the field of elder care, promising the assistance of "senior care specialists" or "personal family consultants...they promise "FREE" advice in selecting appropriate long-term care arrangements, particularly for people whose needs are less than those of nursing home residents."

"These companies, which fall under the catch-all category of long-term care referral services, are the cyberspace era's quick fix solution for the growing number of Americans seeking non-nursing home institutional care for their aging parents, relatives and significant others. Unfortunately, this purported expert assistance in navigating this bewildering world of assisted living is, at best, a hit-or-miss proposition."

Unlike highly trained professions like nursing, social work and psychology, Spiegel points out that there are no formal education, training, regulatory or professional ethics standards for people hired as "long term care specialists" by Internet placement services.

"Granted, a small number of universities -- the University of Southern California's Davis School of Gerontology and the University of Florida's College of Public Health are two examples -- offer certification programs in geriatric care management. However, even this impressive title is not yet subject to formal state licensing or regulation. As a result, referral services are free to hire whomever they choose, irrespective of training and prior job experience."

"Meanwhile, the services these Internet agencies provide may not be violating any laws", Spiegel concedes, "but their advice should be viewed with caution." In his article, Spiegel calls attention to the financial conflicts of interest inherent in the business model these companies are built on. "For example," Spiegel says, "a company's assistance often may be free to the consumer, but the placement agency typically receives a handsome payment from assisted living facilities for each successful referral. This amount can be 50 percent or more of the resident's first monthly rent payment.. the commission for a single referral to one of these facilities may be $3,000 or more."

"Since the salary of placement service employees often consists of a percentage of the employer's compensation, there is an obvious incentive to steer consumers to the highest bidder. Or, at the very least, to refer only to those facilities with which the placement service has reimbursement contracts".

"Because it is unlikely that the free placement agency's employees will be a nurse or social worker -- a professional who has ethical and regulatory strictures requiring the disclosure of third party fees -- they will be under no obligation to reveal this fee structure... a casual Web search shows that many do not, preferring instead to use the word "free" as a lure."

"The alternative to free referral services is to hire a brick-and-mortar geriatric care management agency. These agencies typically employ licensed professionals with training in geriatric issues who typically meet with both the prospective resident and his or her caregivers as part of a comprehensive multi-hour evaluation process. A listing of these agencies, arranged by region, agency name or zip code, can be found on the website of the National Association of Professional Geriatric Care Managers. "

To read the complete article follow this link:
http://www.kaiserhealthnews.org/Columns/2011/July/072811spiegel.aspx

Home Care for Frail Elders Will Become Scarce if Aides Don't Receive a Fair Wage

2011-07-27T07:39:00.000-04:00

July 20, 2011, 12:32 pm

A Fair Wage for Home Care Workers

Paula Spann, in her excellent blog in the New York Times -which should be must reading for anyone interested in issues of aging and caregiving. (See link to her blog above), says a home care agency employee that comes to your parent’s residence, changes the sheets and does the laundry, helps him bathe and dress and makes his lunch before moving on to her next client, should be paid a fair wage.

Spann points out that if that aide performed the same tasks in an assisted living facility or a nursing home, she would be covered under the federal Fair Labor Standards Act, like a vast majority of American workers, and would be guaranteed the minimum wage.

But in 1974, when Congress added domestic employees to the act, it exempted those providing “companionship services.” “The idea was to carve out the teenager down the street,” said Catherine Ruckelshaus, legal co-director at the National Employment Law Project. “Companions were more like elder-sitters.”

“To exclude this huge set of 1.8 million home care workers, who are trained professionals, often paid by Medicaid — it’s an enormous unintended consequence,” Ms. Ruckelshaus said.
When lawmakers introduced the exemption, she added, “they weren’t thinking of this industry. It barely existed then.”

But now that industry does exist. Home Instead, for example, employs more than 65,000 caregivers in all 50 states. And the industry wants to keep the exemption right where it is. Compel such agencies to pay workers more, executives warn, and they’ll have to raise prices for consumers. “There’s only so much a senior and a family can afford to pay,” Paul Hogan, chairman of Home Instead, told me in an interview.

And there's a certain minimum amount that workers need to be paid to keep a roof over their head and buy groceries. Despite the terrible rate of unemployment in this country, our economy seems to be creating an increasing amount of low wage jobs. These jobs are in areas like the restaurant and tourism industry, telemarketing, retail and othe fields outside of the health care industry.

We are already faced with a growing shortage of health aides as the population ages and the need for home aides grow, the pool of underpaid workers will simply migrate elsewhere.
Bob O'Toole edits this blog.
Comments are welcome
Write to Bob at bob@elderlifeplanning.com

For Two-thirds of Older Adults, Family Members Are the Only Source of Care

2011-07-26T18:19:00.000-04:00

More about last weeks blog post on the growing burden of family caregivers as frail elders live into their 80's and 90's and government support dwindles.
Tuesday, Jul 26, 2011

Family Caregivers Take on More Caregiving Responsibilities While Congress slashed the Medicaid Program that Pays for Health Care and Elder Care for the Poor

An AARP report released last week reveals that 62 million family caregivers in the United States couldn't pay for the quality of care they give their loved ones. And according to AARP the nation couldn't pay for it, either.
Family caregivers - increasingly, middle-aged offspring taking care of their elderly parents - provided $450 billion worth of unpaid home care in 2009, says AARP. That's more than the country's total Medicaid spending that year.

"If the family caregiver were no longer available, we'd see an immediate rise in nursing home use and rehospitalization," said Susan Reinhard, AARP senior vice president for public policy.
"Being a family caregiver is becoming a fact of life, and it's becoming more complicated because of the increasing demands of health care."

Poor and Disabled People on Medicaid could be in "Grave Jeopardy"

2011-07-13T12:14:00.000-04:00

It's beginning to look like the President and Congress will attempt to solve the nation's budget deficit and growing debt problem on the backs of the poor and disabled instead of reforming U.S. tax policy that provides huge tax breaks for oil companies and the top 5 percent of America's wealthiest citizens.

According to an editorial in The New York Times on July 5th, cuts in Medicaid, the joint federal and state health insurance for the poor and most vulnerable, "could lead some states to reduce the benefits they offer, seek waivers to cut people from the rolls, or reduce their already low payments to hospitals and other providers."

"...In tough economic times, Medicaid enrollments typically soar as government revenues shrink, adding budget woes."

House Republicans led by Paul Ryan want to turn Medicaid into a federal block grant program that would grow slowly and shift more costs to states and patients. The Republican proposal would cut $1.4 trillion over 10 years — roughly a third of the more than $4 trillion in projected federal spending in that period.
President Obama, who would retain the Medicaid expansion, has proposed a cut of $100 billion, which would be much more manageable. "The great danger in proposing $100 billion in cuts at the start is that Republicans will take that as an opening bid that can be negotiated upward, toward the unreasonable Ryan-level cuts the House has already approved."

According to the Times, "Congressional Democrats and advocates for the poor are most worried that the administration will use a new “blended rate” for federal matching funds — which would replace a patchwork of matching formulas for poor people and children with a single rate for each state..."

"[The President] must be careful not to trade away his goal of near-universal coverage to burnish his credentials as a deficit-cutter. http://www.nytimes.com/2011/07/06/opinion/06wed1.html?_r=1

Bob O'Toole is Editor of this blog.
Your comments are welcome
Bob can be reached at
bob@elderlifeplanning.com

U. S. Health Care Consistently Underperforms Relative to Other Countries

2011-07-10T07:50:00.002-04:00

Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries. This report—an update to three earlier editions—includes data from seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on dimensions of care. Compared with six other nations—Australia, Canada, Germany, the Netherlands, New Zealand, and the United Kingdom—the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. Newly enacted health reform legislation in the U.S. will start to address these problems by extending coverage to those without and helping to close gaps in coverage—leading to improved disease management, care coordination, and better outcomes over time.http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx

U.S. Government Announces An Undercover Sting Operation Against Family Care Doctors

2011-06-27T10:11:00.001-04:00

June 27, 2011
The Boston Globe reports today that “Alarmed by a shortage of primary care doctors, Obama administration officials are recruiting a team of “mystery shoppers’’ to pose as patients, call doctors’ offices, and request appointments to see how difficult it is for people to get care when they need it.

“The administration says the survey will address a “critical public policy problem’’: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice.”

“It will also try to discover whether doctors are accepting patients with private insurance while turning away those in government health programs that pay lower reimbursement rates.”

“Federal officials expect more than 30 million Americans to gain coverage under the health care law passed last year. “These newly insured Americans will need to seek out new primary care physicians, further exacerbating the already growing problem of PCP shortages in the United States,’’ the Department of Health and Human Services said in a description of the project that it submitted to the White House.”

So now we know the truth behind the shortage of primary care physicians. It’s not government incompetence and reimbursement rates in programs like Medicare and Medicaid that are so low that they don’t even cover the doctor’s costs. It’s a secret conspiracy by the doctors to block access to care. And what better solution to stop this evil practice, than an undercover spy operation to break up this clandestine cabal.

“The government is eager to know whether doctors’ offices give different answers to callers depending on whether they have public insurance, like Medicaid, or private insurance, like Blue Cross and Blue Shield.”

According to the Globe article.
The Globe reports that “In a recent study, the Massachusetts Medical Society found that 53 percent of family physicians and 51 percent of internal medicine physicians were not accepting new patients. When new patients could get appointments, they faced long waits, averaging 36 days to see family doctors and 48 days for internists.”
“In the mystery shopper survey, administration officials said, a federal contractor will call the offices of 4,185 doctors — 465 in each of nine states: Florida, Hawaii, Massachusetts, Minnesota, New Mexico, North Carolina, Tennessee, Texas, and West Virginia. The doctors will include pediatricians and obstetrician-gynecologists.”
In other words, our government is setting up an undercover “sting” operation to go after the lowest paid, most demanding, and most needed medical specialists. What a brilliant strategy to solve the PCP shortage. In medicine

“Plans for the survey have riled many doctors because the secret shoppers will not identify themselves as working for the government.”

“In response to the drumbeat of criticism, a federal health official... requested anonymity to discuss the plan before its final approval by the White House.”
http://www.boston.com/news/nation/washington/articles/2011/06/27/secret_survey_to_gauge_doctor_access/

© Copyright 2011 Globe Newspaper Company.
I think this is known in the Obama administration as “transparency”. "Mystery shoppers" what a benign euphemism for using KGB style spying tactics to try to shift the blame for the PCP shortage to the docs that have already chosen to be PCP's"

Suggestion:
To further enhance the government’s efforts to solve the “critical public policy problem’’: the increasing shortage of primary care doctors, including specialists in internal medicine and family practice.” I recommend that our government place posters in medical schools across the U.S. saying: “Uncle Sam wants you to be a family practice physician: Benefits include pay so low that you’ll still be paying of your medical school tuition loans when you retire and you get the added advantage of being under secret surveillance by your government”

Bob O'Toole, President of Informed Eldercare Decisions, Inc is the editor of this blog.
Your comments are welcome as long as they are not "anonymous"
Bob can be reached at bob@elderlifeplanning.com

A Brief Summary of the Long, Sordid History of American Nursing Home Care

2011-06-25T12:47:00.000-04:00

"To become a nursing home owner and operator is not difficult. Many low-horizon individuals start a nursing home merely to make a quick profit. They know little or nothing about nursing care or what is required, and care less about the long term. Their objective is to make as much money as possible, and spend as little of it on residents as they can.

And states are only too glad to let them get away with literal abuse, even murder. "
http://www.cbsnews.com/8601-31727_162-20038384-1.html?assetTypeId=41

A Short History of the Nursing Home Industry and Public Policy on Nursing Home Care
(A Time -Line on How We Got Into this Mess and Why it Will Keep Getting Worse)

1946: The Hospital Survey and Construction Act, known as Hill-Burton, provided funding for constructing state-of-the-art hospitals. In the 1920s, hospitals began to be seen as "Houses of Hope," whereas before they were places where poor people recuperated or died.

1950s: Significant amendments to the Social Security Act included a requirement that states must establish some form of licensing for nursing homes. They also lifted a ban on providing benefits to residents of public facilities and channeled federal moneys to for profit health service providers.

1954: A change in federal law provided grants for the construction of nursing homes "in conjunction with a hospital" in an attempt to raise the quality of care. The change meant that the physical construction of nursing homes began to be modeled after hospitals.

1960: The first major nursing home scandals appeared in New York and elsewhere, uncovering

noncompliance in staff and code requirements, and financial irregularities.

July 30, 1965: Without a federal assistance program to help pay for the care of elderly or disabled, most states sent their impoverished citizens to "poor farms" or "almshouses." The homes were known for their dilapidated facilities and inadequate care, and states appeared to encourage the stigma as a motivating factor to keep people from relying on them.

July 30, 1965, President Lyndon B. Johnson Proclaimed "Thirty years ago, the American people made a basic decision that the later years of life should not be years of despondency and drift. The result was enactment of our Social Security program… Compassion and reason dictate that this logical extension of our proven Social Security system will supply the prudent, feasible, and dignified way to free the aged from the fear of financial hardship in the event of illness."

1968: Congress passed legislation known as the "Moss Amendments," which provided comprehensive

legislation to improve nursing homes and raise institutional standards.

April 1969 : In response to overwhelming costs sparked by the enthusiastic response to Medicare, the then-Department of Health and Human Services distributed "Intermediary Letter 371," stamping out much of the coverage for nursing homes the programs had initially allowed. The sudden change in policy left thousands of elderly and their families with bills they would never be able to pay off. "From the time of Intermediary Letter 371 on, Medicare was no longer a significant factor in the nursing home industry. At great cost, with great confusion, and not inconsiderable pain to thousands of old people and their families, Medicare was finally doing, relative to nursing homes, what its sponsors had first intended - hardly anything." (Bruce Vladeck, author, public health advocate)

1971: With most nursing homes across the country unable to comply with the standards set by the

government, "the Miller Amendment" offered states an alternative to the costly changes. It established a new standard known as "intermediate-care facilities." This new classification meant the facility qualified for federal reimbursement, but did not require the same amount of skilled nursing or resources, thus costing the government less and lowering standards of care.

1972: One of the largest pieces of legislation ever passed, Public Law 92-603, contained a number of reforms for nursing homes, including a new policy that Medicaid would reimburse nursing homes on a "reasonable cost-related basis," with the hope that the facilities would provide better care.

Previously, most states used relatively arbitrary fee schedules.

Mid 1970's: Nursing home scandals again broke across the country, demonstrating provider fraud and poor care. The scandals brought nursing homes into the political arena, but few changes were enacted.

1981: Federal legislation known as the Boren Amendment required states to ensure "reasonable and

adequate" provider reimbursement rates. A couple years later, federal courts found the amendment was indeed enforceable in court.

1985: A report by the Institute of Medicine on nursing home regulation became the basis for legislation, contained in the Omnibus Reconciliation Act (OBRA) in 1987, that was the largest overhaul of federal regulations for nursing homes.

1990's: In response to federal payment incentives, a new field of sub-acute care emerges to provide care for people released from hospitals who still need more care than found in intermediate-care nursing facilities.

1997: After a period of particularly rapid growth in Medicare nursing home expenditures, the Balanced Budget Act cuts the amount of money Medicare pays nursing homes, triggering the bankruptcy of four or five large nursing home chains. The Boren Amendment is repealed.

2005: This snapshot report examines nursing home care in California and uncovers problems with staffing, quality of care, regulatory compliance, and financial stability.

The report notes serious problems in California's nursing homes:

•Only a small percentage of the state's freestanding nursing homes meet the standards recommended for staffing levels to provide good nursing care.
•Continuing high staff turnover threatens quality of care. More than two-thirds of the nursing staff in

California's nursing homes left their jobs in 2003.
•Many residents show clinical signs of poor care as a result of being left in bed all or most of the time, or being placed in physical restraints.
•Most nursing homes do not meet government compliance standards for care and safety. About 15% of homes were cited for very serious quality of care problems or substandard care, which causes harm or jeopardy to the health of residents. Some 77% had serious noncompliance with federal care and safety regulations during their most recent mandatory inspection.
•Half of the state's nursing homes reported negative or zero profit margins.
The snapshot illustrates the state of California's long term care facilities as they face growing demands and diminishing resources.
Read more:

http://www.chcf.org/publications/2005/08/snapshot-californias-fragile-nursing-home-industry-2005#ix

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Bob O'Toole is the Editor of this blog. To contact him directly send an e-mail to: bob@elderlifeplanning.com

Bob O'Toole, MSW, LICSW
President
Informed Eldercare Decisions, Inc.
450 Washington Street-Suite 108
Dedham, MA 02026
781-461-9637 OR Toll free 1-800-375-0595
Toll free fax: 866-776-9593
Creators of the Elder Life Planning for Organizations program (ELPO) a nationwide, low cost, caregiver support program for employers, associations, banks, credit unions, labor unions and religious organizations.

Caring for Aging Parents Will Cost Boomers $3 Trillion

2011-06-20T10:01:00.000-04:00

Caring for Aging Parents Will Cost Boomers $3 Trillion

According to the just-released MetLife Study of Caregiving Costs to Working Caregivers: Double Jeopardy for Baby Boomers Caring for Their Parents, the nearly 10 million Americans who are providing care for their aging parents will lose an estimated $3 trillion in wages, pension and Social Security benefits to do so. The study, produced by the MetLife (MET) Mature Market Institute in conjunction with the National Alliance for Caregiving and the Center for Long Term Care Research and Policy at New York Medical College, reports that the average lifetime losses are $324,000 for women and $283,716 for men.

"Nearly 10 million adult children over the age of 50 care for their aging parents," said Sandra Timmermann, ED.D., director of the MetLife Mature Market Institute. "Assessing the long-term financial impact of caregiving for aging parents on caregivers themselves, especially those who must curtail their working careers to do so, is especially important, since it can jeopardize their future financial security."

Source: http://www.dailyfinance.com/2011/06/15/caring-for-aging-parents-will-cost-boomers-3-trillion/

“What Do You Mean Medicare Doesn’t Pay For It?”

2011-06-13T12:34:00.001-04:00

An Important new book that should be read by any family facing the challenge of caring for an aging parent is "A Bittersweet Season: Caring for Our Aging Parents — and Ourselves” written by Jane Gross,

"I have never met anyone who didn’t ask, with shock and dismay, “What do you mean Medicare doesn’t pay for it?” They assume, as I did, that.. {elders} have universal health care . Alas, Medicare covers only medical or surgical procedures. If what an old person needs, as most will after the age of 85, is custodial care, they, and their children, are on their own. [There are]... traps in choosing a long-term-care insurance policy, a residential facility, a home health aide or in applying for Medicaid when their funds are exhausted, among other complicated decisions."

"...at the hub of the wheel is public policy, which fails to reckon with the fact that those 85 and older are our fastest-growing population group, and that a vast majority will require more than two years of custodial care; that 77 million baby boomers are heading toward old age and frailty themselves; and that America is unprepared for what many consider a public health emergency. One can’t navigate this system on behalf of a parent, or prepare for one’s own future, without understanding that..." Jane Gross, author of “A Bittersweet Season: Caring for Our Aging Parents — and Ourselves” New York Yimes, June 12, 2011

Kirkus Reviews said the following about A Bittersweet Season" in a review on March 15, 2011

"A New York Times reporter helps readers face a final, difficult journey."

"Americans are living longer than ever before, and most senior citizens will eventually become dependent on others for care. Gross offers advice for those already caring for their aging and dying parents and issues a wake-up call to those who think they are prepared should the time come. Her tone is straightforward, but not cold or clinical, when she shares the heartbreaking story of her aging mother, who died in a nursing home. With well-written and researched prose, Gross debunks misconceptions about assisted-living facilities and offers eye-opening anecdotes about Medicare and Medicaid, including how her own upper-middle-class mother ended up on Medicaid and virtually penniless due to health-care costs. The author also gives gentle guidance for understanding the biology and psychology of aging and ways the adult child can best help the parent. For some readers, the most uncomfortable part of the book will be Gross' mother’s choice to die by refusing to eat or drink. This may be controversial, but the subject is not treated lightly, and many conversations occurred beforehand. With a poignant, honest voice, the author recalls her mother’s suffering. This book will remind readers that quality-of-life issues are important, and will hopefully prompt those types of discussions. There are no easy answers here, because there are none."
A thought-provoking resource for end-of-life care.
http://www.kirkusreviews.com/book-reviews/non-fiction/jane-gross/bittersweet-season/

You can purchase the book at the following link: http://www.amazon.com/Bittersweet-Season-Caring-Parents---Ourselves/dp/030727182X/ref=sr_1_1?s=books&ie=UTF8&qid=1307983639&sr=1-1

bob@elderlifeplanning.com

FINANCIAL ABUSE OF OLDER AMERICANS HAS INCREASED SINCE 2008

2011-06-01T16:33:00.000-04:00

June 5,2011 is the 6th Annual World Elder Abuse Awareness Day (WEAAD).

Silver Inning Foundation(SIF) a NGO working with senior citizens and their family members in association with INPEA (International Network for Prevention of Elder Abuse)

LATEST DATA FROM METLIFE MATURE MARKET INSTITUTE

Older Americans are losing $2.9 billion annually to elder financial abuse, a 12% increase from the $2.6 billion estimated in 2008, according to The MetLife Study of Elder Financial Abuse, released today from the MetLife Mature Market Institute.

The study was produced in collaboration with the National Committee for the Prevention of Elder Abuse (NCPEA) and the Center for Gerontology at Virginia Tech.

The study can be downloaded via: www.MatureMarketInstitute.com.

Cuts to Elder Services are Not Limited to U.S.

2011-05-19T15:57:00.000-04:00

I received this alert from my eldercare professional colleague in England

From: Jackie Brook
Date: 5/19/2011
Subject: Elderly Care in the UK
Hi Robert
I've added your comment to the web site http://www.careindustrynews.co.uk/

If you can give the American spin on this or any news story you are welcome to comment.

Our government is about to announce various restructures regarding cuts- Due to an aging population the local councils simply can't afford to cover costs but are required to make huge cuts which include elderly care- Due to the greed of our previous government.

The chances are that several ex-MP's are on the board of groups that have been run by banks that should have failed!

Jackie

"Iceberg For Southern Cross Care Homes How to raise £100million? Off load over 200 Care Homes!

Southern Cross have seen their shares plunge to new depths. Their Chairman Ray Miles stepped aside in April- Handing over to Christopher Fisher whose back ground includes being Managing Director of Lazard Investment Bank and Vice Chairman of Corporate Finance for KPMG .
As well as this they’ve approached the government for a ‘Bankers style’ bail out. Now call me old fashioned but just how will this work?
Southern Cross have no assets, the banks did at least have those. Occupancy is down and many of the properties occupied require updating and/or complete refubishment.

So the idea is to walk away from 50 homes that ‘Are not fit for purpose’ regroup, sell off between 100 and 200 to another operator and become a smaller company.

Over 31,000 elderly people are relying on a quick fix- as are their families. Not to mention the dedicated staff that work for Southern Cross So surely one of the questions should be ‘How will they pay it back?’

Editors note: Southern Cross Healthcare (Group plc) is a independent provider of health and social care services in the UK, meeting the needs of elderly and younger people in care centres. The group is the largest provider of care homes and long term care beds in the United Kingdom, operating over 750 care homes, 37,000+ beds and employing around 41,000 staff.[1] Following rapid expansion financed by the sale of leases of its homes, its shares fell 98% from early 2008 to early 2011, reducing its market value from £1.1bn to around £12m.[2]

Chart of Current and Projected Growth in World Aging Population

For the full details of these serious cuts due to the greed of investment bankers who take their money and run, leaving devastated lives in their wake follow this link http://www.careindustrynews.co.uk/2011/05/an-iceberg-for-southern-cross-care-homes/

What Medicaid Cuts Will Mean For Seniors: U.S. is facing a massive care crisis.

2011-05-19T11:17:00.000-04:00

What Medicaid Cuts Will Mean For Seniors

By Howard Gleckmanon May 18th, 2011
Permalink

Kaiser Health News published my column today on what Medicaid cuts would mean for seniors and others with disabilities. While most of the public and many policymakers never think about the importance of the Medicaid safety net for these people, the program is the nation’s largest single payer of of long-term care supports and services. If future Medicaid benefits are reduced and most middle-class poeple have no savings or insurance to protect against disability and frail old age, the U.S. is facing a massive care crisis.
Kaiser also published a nice interview with Martha Roherty, executive director of the National Association of States United for Aging and Disabilities, on additional cuts in non-Medicaid services for the elderly and others with disabilities. Many of those programs, such as transportation, home-delivered meals, and subsidized housing provide the critical infrastructure people need to age in place. Thse cuts, combined with those for Medicaid, will add to the challenges for the elderly and their families.
++++++++++++++++++++++++++++++++++++++++++++++++++++
Someone you love will almost certainly need long-term care services before they die. Nearly 70 percent of our parents will receive such help sometime during their old age-usually at home, though often in a nursing home. It will last for an average of three years, though one in five will need this assistance for five years or more. The costs are crushing-often $75,000-a-year or more. And the weight of 77 million aging Baby Boomers will devastate our nation's already fragile system for funding this critical day-to-day assistance. How can we repair the tattered safety net that is so essential to our aged and disabled?

Caring for Our Parents tells the sometimes painful, sometimes uplifting, and always compelling stories of the families who struggle every day with the care needs of their loved ones. If you are a member of this club, think you may be soon, or know someone who is, this book offers stories, information, inspiration, and hope. It also presents new ideas for how America can do a better job both providing this care and paying for it.

You can buy Howard's book Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Crisis at http://www.amazon.com/Caring-Our-Parents-Inspiring-Solutions/dp/0312380992/ref=sr_1_1?ie=UTF8&s=books&qid=1236906118&sr=1-1

Pitting Low Wage Workers Against Taxpayers and Patients

2011-05-03T10:07:00.000-04:00

Home care agency owners are attacking a requirement that their workers receive a living wage in the New York City metropolitan area as a last-minute bargain with the state's most powerful health care union that will actually increase the cost of providing services.

The Association for Better Healthcare, which represents licensed home care agencies in New York, today lashed out at what it called a "political deal" that would cost the state's taxpayers more than $400 million in additional Medicaid costs and benefit the state's largest union.

A bill in both houses supported by Gov. Andrew Cuomo would grant a "living wage" to thousands of home health care workers in New York City as well as Nassau, Suffolk and Westchester counties, which all have living wage laws. No other regions would be affected.

But the Association for Better Healthcare said the living wage would add costs and benefit thousands of 1199 SEIU workers even as government workers face job cuts and pay freezes. The association said the hike would hurt the smallest home care agencies most, while benefiting large non-profits.

"This last minute deal will help a handful of nonprofit agencies including the Visiting Nurse Service of New York at the expense of 400 small health care companies," said Barry Weiss, a spokesman for Preferred Home Care in Manhattan.
Others said the hike would be easier for large nonprofit agencies such as Visiting Nurse Service of New York to handle, since they often can attract higher reimbursements. The Association for Better Healthcare said larger agencies that accept Medicaid are able to pay as much as $23 per hour.
"When agencies close down, where is the work going?" Todd Stevens, home health aide coordinator for Brooklyn-based Quality Home Health Care Services, asked. "All the work will end up at four or five larger agencies. If they force the living wage, the smaller agencies will be crushed."
He said that could boost efforts to unionize this industry, even after efforts to unionize a patchwork of smaller agencies failed when some of the larger agencies formed unions.

Consolidation, however, could lead to a more easily regulated industry, less vulnerable to abuses and mismanagement. And home care providers who belong to SEIU, which describes home care as its "largest single division-and the fastest growing", said they need a living wage in these regions to survive.

"You can't imagine what it is like trying to pay my bills in Queens on $15,000 a year," Dolores Molina was quoted as saying in an article on the union website following a rally a few days ago. "When I explained to the legislators the type of work we do, how we care for very sick people who have no one else - and that we make $7.50 hour - most of them were shocked."

Stevens said the absence of a voice on behalf of smaller home care agencies was likely one reason that the legislation has advanced at a time when the state is cutting money to home care agencies and seeking ways to save, not increase, expenses.

This is an excerpt: To read the entire article go to the following link: http://www.allbusiness.com/government/elections-politics-campaigns-elections/15551435-1.html

WORKERS AGED 65+ INCREASE THEIR LABOR PARTICIPATION

2011-05-02T17:18:00.000-04:00

"The labor force participation rate of persons aged 65+ has increased markedly in recnt years. In 2010, an average of 17.4% of persons aged 65+ were in the labor force, up from 10.8% 1985. The number of labor force participants aged 65 and over has increased by more than 15% (or by 915,000 workers and jobseekers) since December 2007. As of January 2011, nearly 6.9 million members of the labor force (4.5% of the total) were at least 65 years old," according to a 2011 analysis of BLS data.

Rix, S. E. (2011). Unemployment down but overall job growth remains anemic. (Fact Sheet No. 210). Washington, DC: AARP Public Policy Institute. (p. 6) Retrieved from http://assets.aarp.org/rgcenter/ppi/econ-sec/fs208-employment

Long-term Care Insurance is Worth Looking Into But Avoid These Companies

2011-04-26T14:27:00.000-04:00

During the three years I've been writing this blog, I have both recommended private long-term care insurance as coverage that can be well worth the investment. I've also warned consumers and their advisors about the abusive sales practices that have been all too common in the long-term care insurance industry. The sales of LTC insurance in the U.S. over the last 15 years has been dismal. Estimates are that less than ten percent of
those over age 55 who can afford to pay for this coverage, have purchased a policy.

The insurance industry has only itself to blame. The excellent companies such as John Hancock, MetLife, UNUM, Genworth, and many other reputable carriers have done nothing to police their own industry and sat on the sidelines while a few sleazy companies and corrupt insurance agents gave the product a bad name.

Instead of taking the lead and using creative approaches to raise the public awareness of the critical importance of this coverage, the good companies joined the sleazeballs and spent millions of dollars lobbying congress to pass a bill to punish those who used legal means to protect their homes against the devastating cost of a nursing home stay. They were convinced that so called "Medicaid Planning" was the reason they were not selling policies. Since the typical homeowner using this method of legal planning is in their 70's and 80's and in poor health, they were uninsurable anyway. Since President George Bush signed the bill into law in 2006, LTC insurance sales have declined!

I still recommend that healthy consumers, in their 50's and 60's, who can afford the premium take a serious look at LTC Insurance as a retirement planning tool. Paying $2500 to $5000 a year in premium can allow you to build a "savings account" to pay for care at home or in a facility of more than a million dollars. Which is what care will cost in 20 years for 3 -5 years of care.

BUT AVOID THESE COMPANIES!
Conseco, Bankers, and Penn Life have had numerous complaints filed with state regulators over long-term care insurance, particularly in regard to claims handling, price increases, and advertising methods.
Conseco has more than $33 Billion in assets and pays its president more than $2.6 million annually
Unfortunately, Conseco uses the deteriorating health of its policyholders to its advantage because the company knows if it waits long enough to pay out claims, its customers will die.

Mary Beth Senkewicz, a former senior executive at the National Association of Insurance Commissioners (NAIC), summed up the tactics of the long-term care insurance industry quite succinctly: "The bottom line is that insurance companies make money when they don't pay claims...They'll do anything to avoid paying, because if they wait long enough, they know the policyholders will die."
Conseco and its subsidiaries, Bankers Life and Casualty and Penn Treaty American, have had a mountain of complaints from policyholders who have not been satisfied with the way their claims have been handled. Conseco, Bankers, and Penn Life have had numerous complaints filed with state regulators over long-term care insurance, particularly in regard to claims handling, price increases, and advertising methods.

Former employees of Conseco and its subsidiaries have spoken out about the company's claims-handling practices. Former Bankers Life agent Betty Hobel said Conseco and Bankers Life "made it so hard to make a claim that people either died or gave up." Another former Bankers Life employee, Robert Ragle said "[t]heir mentality is to keep every dollar they can." In a 2006 deposition, Bankers Life claims adjuster Teresa Carbonel described how she was forbidden from calling physicians or nursing homes to request missing paperwork before denying claims. Another Conseco employee, Jose Torres, testified in a separate deposition that he was told to withhold payment on claims until the policyholder submitted documents not even required under the terms of the policy.

In May 2008, NAIC announced it had brokered a settlement between Conseco and 39 states and the District of Columbia over a pattern of abuses in its long-term care business. As part of the agreement with state insurance commissioners, Conseco and its subsidiaries were fined $2.3 million and ordered to pay $4 million in restitution to policyholders.
http://www.getclaimhelp.com/public-adjuster/10-worst-insurance-companies-deny-claims-raise-premiums.html#conseco

Be sure to read our warnings earlier in this blog about the disgraceful practice of buying bogus credentials with fancy sounding names that can make an unemployed construction worker sound like a highly qualified eldercare professional
"The Society of Certified Senior Advisers, one company that doles out dubious financial credentials, is a for-profit company that has trained 24,000 enrollees since it was started in 1997. Its founder, Edwin J. Pittock, is a former mutual fund executive who was twice suspended by the Securities and Exchange Commission.

"The degree isn't worth the paper it's written on," said T. Kevin McElreath, a financial adviser in Milford, Mass., who took the certified senior adviser exam but does not use the credential. For many agents, he said, "it's a scam, a way to put a title on a business cardthat impresses gullible seniors."

http://old-mutual-financial-network.info/expose-investigation.html

http://www.newsobserver.com/2010/05/17/486075/swelling-senior-ranks-wont-lack.html#ixzz18segbZFL
http://www.msnbc.msn.com/id/24095230/

http://elderplanner.blogspot.com/search?q=certified+senior+advisor

www.marketwatch.com/.../granny-and-clyde-when-seniors-scam-seniors- 2010-12-20 -

http://www.youragingparents.net

http://www.linkedin.com/in/elderlifeplanning
http://www.newsobserver.com/2010/05/17/486075/swelling-senior-ranks-wont-lack.html#ixzz18segbZFL
http://www.msnbc.msn.com/id/24095230/
http://elderplanner.blogspot.com/search?q=certified+senior+advisor

www.marketwatch.com/.../granny-and-clyde-when-seniors-scam

Older Workers Can't Afford to Retire But Many Can't Find Work In Recession

2011-04-25T18:29:00.000-04:00

ONE IN EIGHT OLDER ADULTS AMONG LONG-TERM UNEMPLOYED

"Among unemployed adults over age 65, one out of eight (12.15%) had faced 99 weeks or more of unemployment, sometimes called very long-term unemployment. For unemployed adults aged 55+, 11.51% had spent almost the last two years looking for work, considerably higher than the figure of 6% among unemployed workers under age 35," according to a 2011 analysis of BLS data."
Rix, S. E. (2011). Unemployment down but overall job growth remains anemic. (Fact Sheet No. 210). Washington, DC: AARP Public Policy Institute. Retrieved from http://assets.aarp.org/rgcenter/ppi/econ-sec/fs208-employment.pdf

Older Adults Struggle in Job Search

While many older workers may need—and want to have—jobs, their plans may not be realized according to a new study by Boston College’s Sloan Center on Aging & Work and the Heldrich Center for Workforce Development at Rutgers University.

The "New Unemployables" study reveals that, among job seekers unemployed during the recent recession, adults aged 55+ are finding it increasingly difficult to land a job and are more likely to remain out of work longer than younger job seekers. The study reveals that the vast majority (84%) of older workers who were unemployed in August 2009 were still unemployed in March 2010. More than two thirds of older job seekers (67%) included in the survey reported looking for work longer than a year.

As a result of their prolonged bouts of unemployment, many older job seekers have altered their retirement plans and dipped into their savings to make ends meet. “Most older workers feel they cannot afford to consider retirement,” says Carl Van Horn, Director of the Heldrich Center and co-author of the New Unemployables study. “In the short term, they need access to more intensive job search assistance, training, and education to help ensure their skills fit the needs of today’s economy. In the longer term, older workers hope that more employers will reassess their hiring and retention policies and do more to welcome and accommodate this growing segment of the workforce.”

The study also explores the economic, social and emotional impacts experienced by people who lost jobs during the recession. Analyses indicate that older survey respondents believe that age discrimination has also played a major role in their inability to find a new job.

A recent Cover story in Newsweek supports the age discrimination issue.

The Newsweek article cites Brian Goodell, of Mission Viejo, Calif., who won two gold medals in the 1976 Olympics, and Brock Johnson, of Philadelphia, was groomed at Harvard Business School and McKinsey & Co as examples. Goodell is 52 now and enjoyed a comfortable career in commercial real estate. Until 2008, when he was laid off. Two years of relentless job searching and he is still unemployed."As a 17-year-old swimmer, he set two world records. As a 52-year-old job hunter, he’s drowning." says Newsweek.

Johnson resigned in 2009 as CEO of a Fortune 500 company. He was confident he would quickly find a new job, but at 48, he’s still unemployed.

It used to be that if you had a college degree and a solid résumé you could count on keeping your job of finding a new one easily.

"But not this time.", according to Newsweek.In one of the grimmest articles I've read about this never ending recession, the magazine says if you're a college educated white male and over 45 you're a "Dead Suit Walking".

The suits are “doing worse than they have at any time since the Great Depression,” says Heidi Shierholz, a labor economist at the Economic Policy Institute. And while economists don’t have fine-grain data on the number of these men who are jobless—many, being men, would rather not admit to it—by all indications this hitherto privileged demo isn’t just on its knees, it’s flat on its face. Maybe permanently. Once college-educated workers hit 45, notes a post on the professional-finance blog Calculated Risk, “if they lose their job, they are toast.”

Through the first quarter of 2011, nearly 600,000 college-educated white men ages 35 to 64 were unemployed, according to previously unpublished Labor Department stats. That’s more than 5 percent jobles and a historic change from the last recession, when about half as many lost their oxford shirts. The number of college-educated men unemployed for at least a year is five times higher today than after the dotcom bubble.

In New York City, men in the 35-to-54 kill zone have lost jobs faster than any other group, including teenage girls, according to new data from the Fiscal Policy Institute.

Jacquelyn James, Research Director of the Sloan Center on Aging & Work says, “Being summarily dismissed from the workforce can really be damaging to the self esteem of older adults—feelings of embarrassment can also make it difficult to reach out to networks and friends. And such stress and anxiety can further hinder an older job seeker’s prospects, or even their desire to actively search for a job.”

Indeed, the data described in the New Unemployables study revealed that a large majority of older workers reported symptoms of stress such as uneasiness and restlessness, strain in family relations, changes in sleeping patterns, and avoidance of social situations.

To read/download The New Unemployables: Older Job Seekers Struggle to Find Work During the Great Recession—Comparing the Job Search, Financial, and Emotional Experiences of Older and Younger Unemployed Americans click here »

ABOUT THE HELDRICH CENTER’S WORK TRENDS STUDY

In August 2009, the Heldrich Center for Workforce Development, working with Knowledge Networks and its online nationally representative probability sample, surveyed 1,202 men and women who had been unemployed at some point in the preceding year. This data was used to develop the Heldrich Center’s September 2009 report, “The Anguish of Unemployment”, part of the Center’s Work Trends series.

In March 2010, the Heldrich Center completed follow-up questionnaires with 908 of the original group, for a 76% panel completion rate. These new data were used for the Heldrich Center’s May 2010 Work Trends report, “No End in Sight: The Agony of Prolonged Unemployment.”
Sources for this article include

http://www.heldrich.rutgers.edu/

http://assets.aarp.org/rgcenter/ppi/econ-sec/fs208-employment.pdf

http://www.bc.edu/research/agingandwork/archive_news/2010/2010-11-16.html

http://www.newsweek.com/2011/04/17/dead-suit-walking.html

http://economix.blogs.nytimes.com/tag/john-j-heldrich-center-for-workforce-developments-at-rutgers-university/

Waving The U.S Flag and Insisting "We're Number 1!" Won't Solve America's Problems Part 2

2011-04-10T11:52:00.001-04:00

See Part two of this commentary above.

The combination of tax cuts and higher military spending overwhelmed more modest reductions in spending on domestic programs. As a result, the federal budget deficit swelled from a deficit of $74,000 million in 1980, the dawn of Reagonomics. For decades, gullible Americans were lulled into believing that they could spend more money and pay less taxes without going into debt. Since embracing what former President, George H.W. Bush rightly called "voodoo economics" (before the offer of the vice presidency suddenly made him a convert), our country has accumulated more than $13 Trillion of combined debt according to the U.S. Treasury Department. The only years in which the U.S. budget had a surplus were the last two years of the Clinton administration 1999 and 2000.

Suddenly, after thirty years of Reaganomics The consequences of this profligacy are playing out in dramatic fashion. Drastic cuts to federal programs that support poor, abused and neglected children, public education, repairs and new construction of our transporation infrastructure, and everything from the national parks to the Center for Disease Contol will soon be enacted by congress.

The deepest long-term funding cuts will be in those programs that provide services to frail elders including Medicare and Medicaid.

In the world that Boomers will pass along to their children, America is widely held in contempt, prosperity looks to more and more people like a mirage, and things are generally going to hell.

The notion that America and Americans are special, among all the peoples of the earth, is sometimes called “American exceptionalism.” Because of our long history of democracy and freedom, or because we have a special mission to spread these values (or at least to remain a shining example of them), or because of our wealth, or because of our military strength, our nuclear arsenal, our wide-open spaces, our pragmatism, our idealism.

This may have given us the impression that we could ignore the other kind of rules —the ones that are imposed by reality and therefore are self-enforcing. These are rules such as, “You can’t have good ice cream without fat” or “You can’t borrow increasing amounts of money indefinitely and never pay it back, because people will eventually stop lending it to you.” No country is special enough to escape these rules.
This conceit that we’re the greatest country ever is self destructive. If people believe it’s true, they won’t do what’s necessary to make it true. The Brits, who suffer no such delusion (and who, in fact, cherish the national myth of being people who smile through adversity), have just accepted cuts in government spending that no American politician — even a tea bagger — would dream of proposing. Maybe these cuts are a mistake or badly timed, but when the British voted for “change,” they really got it.

Editors Note: Much of the content of this article concerning "American exceptionalism" or America is The Greatest Because We Say So, is taken from the writings of Michael Kinsley, especially from articles he has published at Politico.com and The Atlantic Monthly magazine.

One of America's most respected journalists, Michael Kinsley is a columnist for POLITICO. The founder of Slate, and has also served as editor of The New Republic, editor-in-chief of Harper’s, editorial and opinion editor of the Los Angeles Times and a columnist for The Atlantic.

Read more of Michael Kinsley's important observations about the current state of the American economy and the troubled future that lies ahead for this country unless we are willing to do the hard work and make the sacrafices needed to restore America and leave a great country to our children and grandchildren.

http://www.theatlantic.com/magazine/archive/2010/10/the-least-we-can-do/8228/

http://www.politico.com/news/stories/1110/44500.html#ixzz1J85dlhsg

http://www.politico.com/news/stories/1110/44500.html#ixzz1J87Cv8Kc

http://www.politico.com/news/stories/1110/44500.html#ixzz1J86lFfJ9

Waving the American Flag and Insisting that "We're Number One!" Will Not Make Our Problems Disappear-Part 1

2011-04-10T11:49:00.001-04:00

The so called "Baby Boomers", an overly simplistic term that lumps everyone in the U.S. born between 1946 and 1964 into a monolithic group with a universally shared set of values and behaviors, are often given the negative label of the "Me Generation" or praised, as a group, for playing a key role in much of the progress that has been made in American society since World War II.

They made environmentalism, feminism, affirmative action, reproductive rights for women and gay rights a deeply rooted part of our society. While the political and religious extremists continue to fight on to repeal the advance of a civil and civilized society, the likilihood that these "American Ayatollas" will succeed is increasingly remote.

Of course lumping 80 million Americans into a monolithic, single minded segment of the U.S. is absurd. Most so called "Baby Boomer"'s did not take part in America's invasion of Vietnam, neither did most whose date of birth puts them in this demographic, protest that disgraceful episode in our history. The diversity of this group is much greater than it's shared values, behaviors and circumstances.

Americans born in this country during the post World War era are white and black and asian and hispanic, they live in big cities and on small farms, some are rich, most are not. Most baby boomers are politucal moderates, while many have political views that range for the extreme right to the extreme left.

President Obama was born in August of 1961 making him one of the youngest "boomers". Only two other members of this post WWII generation have been elected president. William Jefferson Clinton and George W. Bush. These two former presidents are considered to be of very different political philosophies.

While acknowleging this simplistic label, members of the "Baby Boomer" generation played a major role in creating the technological revolution that revived capitalism. And they did their share of sacrificing: they paid for their own schooling with student loans—becoming the first generation to enter adulthood already burdened by large debts. They also paid, publicly and privately, for their parents’ generation to retire in greater comfort than they themselves can reasonably expect. And now—talk about selfishness—many Boomers are supporting their children, too, into their 20s and beyond.

But he "Boomers"-with the help of their parents, the so called "Greatest Generation",ran up huge public and private debts and continue to do so. These two generations combined embraced the ridiculous notion of "Reaganomics" that promised Americans that they could make huge entitlement committments such as Medicare, fight decades of wars not only resulting in an enormous and needless loss of life but also at a cost of trillions, by borrowing this money from China and elsewhere, instead of paying sufficient taxes required to pay the cost of these committments.

Quick Links to Information and Resources Related to The Care and the Costs of Services for Elders in Need of Services

2011-03-25T12:30:00.003-04:00

Here is an updated list of Quick Links to Information and Resources Related to The Care and the Costs of Services for Elders in Need of Services

Understanding the Costs of Eldercare

http://tinyurl.com/4jnur2j

Protecting Elders from Financial Exploitation
http://tinyurl.com/4ppwyar

Community Banks Can Provide a Valuable Service to the Depositors That Own 80 percent of Deposits
http://tinyurl.com/4tuhjbe

Caregiver Support Programs for Faith Based Communities
http://youragingparents.net

Eldercare Professionals Provide Caregiver Support Services to Patients and Families Participating in Alzheimer's Research

http://tinyurl.com/5wwetzq

Eldercare in an Age of Scarcity: Who Will Care and Who Will Pay is a continually updated resource for family caregivers and professional elder services priders.

This blog is brought to you as a public service by:Informed Eldercare Decisions

450 Washington Street Suite 108
Dedham, MA 02026
781-326-5046
info@elderlifeplanning.com

Informed Eldercare Decisions, Inc. is a private company dedicated to helping our clients make the best care choices for parents and relatives and to help them understand various funding alternatives to pay for care.
Due to the pressures of work, geographic distance, or other demands, it is not always possible for concerned family members to manage the many tasks involved in care giving. Those not well acquainted with the fragmented service delivery system, often find it confusing and difficult to negotiate.

It can especially difficult when a family member is suffering from prolonged mental illness, or neurological diseaes such as Alzheimer's disease and similar forms of dementia, Parkinson's disease, ALS or Multiple Sclerosis.

The uninsured costs of such care can place a strain on the financial resources of those needing care, as well as those caring for them.

We work with professionals of every specialty concerned with elder care planning including geriatric care managers, elder law attorneys, home care providers, health care facilities directors, financial advisors, clinical social workers and nurses.

With more than two decades of experience in the management of complex and difficult caregiving situations, our team can provide a thorough assessment of each situation and create a care plan that addresses the full range of medical, emotional, financial and legal needs. For long-distance caregivers, we can also help to implement the care plan and monitor its effectiveness. Sometimes the most valuable service we provide is the peace of mind our services bring to our clients and their families, allowing them to proceed with their lives.

We also provide services needed by law firms and Trust departments when they are involved with guardianship and conservatorship issues and need clinical services or family counseling and mediation to resolve difficult situations concerning a serious diagnosis or help for family members who are struggling to find the most suitable solution and the optimal care plan for their aging family member.

To learn more about our specialized services and the credentials of our professional staff please click here. http://www.elderlifeplanning.com or contact us by e-mail by writing to info@elderlifeplanning.com

AARP Sues Government Over Reverse Mortgage Foreclosures

2011-03-17T14:28:00.000-04:00

AARP, has filed suit against HUD charging that reverse mortgage borrowers were caught in what amounts to a regulatory bait and switch. AARP's legal arm is suing the Department of Housing and Urban Development (HUD) on behalf of three now-deceased borrowers' surviving spouses who are facing imminent foreclosure and eviction from their homes.

The case involves the spouses of individuals who took out Home Equity Conversion Mortgage (HECM), which are the most widely available reverse mortgage and are administered by HUD. A reverse mortgage allows homeowners who are at least 62 years old to borrow money on their houses. The loans do not have to be repaid until the last surviving borrower dies, sells the home, or permanently moves out.

The borrowers in the AARP case all died, leaving their spouses, who were not listed on the loan documents, living in the mortgaged homes. Because of the housing downturn, the homes are now worth less than the balance due on the reverse mortgage. None of the three spouses -- residents of Indiana, New York and Maryland -- can obtain loans for more than their homes are worth and so are facing eviction.

The suit also charges that HUD is ignoring another provision of the HECM program that protects a surviving spouse from being arbitrarily displaced from the home upon the death of the borrower.

Feds Say 90 Percent of Nursing Homes Employ People Convicted of at Least One Crime

2011-03-04T16:17:00.000-05:00

Study Finds Criminal Pasts of Nursing Home Workers

By ROBERT PEAR Published: March 2, 2011

WASHINGTON — More than 90 percent of nursing homes employ one or more people who have been convicted of at least one crime, federal investigators said Wednesday in a new report. In addition, they said, 5 percent of all nursing home employees have at least one criminal conviction.

The report was issued by Daniel R. Levinson, inspector general of the Department of Health and Human Services, who obtained the names of more than 35,000 nursing home employees and then checked with the Federal Bureau of Investigation to see if they had criminal records.

“Our analysis of F.B.I. criminal history records revealed that 92 percent of nursing facilities employed at least one individual with at least one criminal conviction,” Mr. Levinson said. “Nearly half of nursing facilities employed five or more individuals with at least one conviction. For example, a nursing facility with a total of 164 employees had 34 employees with at least one conviction each.”
“Even some of the better nursing homes have problems with theft, rampant theft of residents’ clothing and personal possessions, including jewelry,” Dr. Harrington said. “People convicted of crimes are often left alone with nursing home residents because the supervision of care is, in many homes, very inadequate.”

A version of this article appeared in print on March 3, 2011, on page A17 of the New York edition..

To read the full article click here http://www.nytimes.com/2011/03/03/us/03nursing.html

Block Grants Would Cripple Long-Term Care Services for Poor Elders

2011-03-03T12:31:00.000-05:00

Howard Gleckman is an author we have mentioned in some previous posts here is the author of "Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Crisis "
Links to his blog and to his book are at the end of this post.

On Tuesday(March 1, 2011) Mr. Gleckman alerts us to some alarming news for anyone who is dependent on the Medicaid program to pay for all or part of their long-term care costs.

"Powerful Republicans are pushing the twin ideas of capping the federal contribution to Medicaid and eliminating federal regulation of the program. These changes would do profound damage to the Medicaid benefit for long-term care, whether it is provided at home or in nursing facilites." says Gleckman

This plan would turn Medicaid from a federal entitlement into a block grant. Over time, states would be responsible for paying a growing share of the program costs but in exchange would have broad flexibility over who to cover and what benefits they'd receive. In such an environment, chances are good that fewer aged and disabled would be eligible for benefits and they'd receive less assistance than they do today. At the same time, providers such as nursing homes and home health agencies would likely get lower Medicaid payments even though the program reimbursements are already at dangerously low levels.

"Today, the federal government pays about 57 percent of Medicaid costs (the actual amount varies from state to state and ranges from 50 percent to about 80 percent). While the elderly and disabled account for only 25 percent of the 50 million Medicaid enrollees, the program spends two out of every three of its dollars on this population. More than one-third of the total Medicaid budget, or $125 billion, went to long-term care supports and services alone in 2009, according to a new study by the Kaiser Family Foundation."
The block grant proposal, says Gleckman, "...is likely to generate major cuts in both benefits and reimbursements. In addition, without minimum federal standards, the differences among state long-term care benefits, already dramatic, would only grow.As a result, residents of one state may receive much better long-term care than residents of a neighboring jurisdiction."

This is a brief Excerpt from Howard Gleckman's blog for more details about Medicaid Block Grants click on the following link: http://abytesgen01.securesites.net/howard_gleckman/2011/03/medicaid-block-grants-would-cr.html

You can purchase Howard's most informative book "Caring for Our Parents: Inspiring Stories of Families Seeking New Solutions to America's Most Urgent Health Crisis " at amazon.com here's the direct link
http://www.amazon.com/Caring-Our-Parents-Inspiring-Solutions/dp/0312380992/ref=sr_1_1?ie=UTF8&s=books&qid=1236906118&sr=1-1

Expanded Services to Caregivers of Aging Parents

2011-02-23T14:50:00.001-05:00

Medicare Reimbursement Limits Time for Geriatric Physicians to Consult with Families

2011-02-23T11:57:00.000-05:00

At a time when a growing number of family physicians are no longer accepting Medicare patients, and the number of those choosing to specialize in geriatric medicine is shrinking, expecting to find quality time with your loved one’s physician is about as likely as calling your local cable television provider and having your call answered by a real live person.

Last year USA Today reported that “The number of doctors refusing new Medicare patients because of low government payment rates is setting a new high, just six months before millions of Baby Boomers begin enrolling in the government health care program.”

Recent surveys by national and state medical societies have found more doctors limiting Medicare patients.

• The American Academy of Family Physicians says 13% of respondents didn’t participate in Medicare last year, up from 8% in 2008 and 6% in 2004.

• The American Osteopathic Association says 15% of its members don’t participate in Medicare and 19% don’t accept new Medicare patients. If physician payments are not increased, the survey shows the number of doctors dropping out of the Medicare program will double.

• The American Medical Association says 17% of more than 9,000 doctors surveyed restrict the number of Medicare patients in their practice. Among primary care physicians, the rate is 31%.

The federal health insurance program for seniors paid doctors on average 78% of what private insurers paid in 2008. Now, in 2011, Congress is faced with the harsh reality of an unsustainable budget deficit and the fact that Medicare costs are the single most expensive item in the budget.

And doctors are only paid for providing direct care to patients, they are not paid a penny for spending quality time with the patient's loved one.

We need to develop a model where non-medical providers like geriatric care managers, (GCM) work collaboratively with physicians to be able to provide services that can facilitate better communication with family caregivers in a more cost effective manner.

The presence of the GCM can serve to assure that information is accurately exchanged between the physician and the elder. Additionally, the GCM can take on the task of assisting with communication in terms of status changes or making or canceling appointments between the physician’s office and the patient. This is often done with phone calls or faxes to the physician or his or her nurse.

Ongoing assessment of a formally isolated patient to the physician.
Through regular visits and contact the GCM is able to provide monitoring of the client ’s overall status. GCM can also arrange for more in-depth regular assessment or provide formal assessment in the areas of health/mental health depending on professional qualifications and certification. The GCM can relay patient concerns while they are at a, “pre-crisis state,” allowing the physician to intervene before a hospitalization or even an urgent, same day, appointment becomes necessary.

Links:
http://www.caremanager.org/
Bob O'Toole, Blog Editor
bob@elderlifeplanning.com

Elder Care Worker Shortage Continues to Grow More Serious

2011-02-17T08:38:00.000-05:00

This Letter appeared in last Fridays NY Times. (February 11, 2011).
It was written in response to an article about labor shortages in Germany, a country who faces a faster rise in their aging population than we in the U.S.do.

“Germany Fights a Lack of Labor, Not Joblessness” (Business Day, Feb. 5) should remind us that our nation, too, faces a severe shortage of workers to care for the elderly.

"While the article notes that Germany will need one million new caregivers by 2030, the United States is projected to need an additional 1.1 million direct-care workers between 2008 and 2018. Yet only 850,000 women ages 24 to 54 — the people who typically fill these positions — are expected to enter the entire United States work force during this period."

"Shortages in the United States will grow even more extreme as we near 2030, and increased immigration is no more likely to resolve our “care gap” than it will Germany’s."
"To close our care gap, we must make these jobs far more attractive — providing better wages, benefits, training and opportunities for advancement. Moreover, at a time when our political leaders are grappling with job creation, improving direct-care worker jobs will not only lead to better care, but it will also help strengthen the economy — particularly within low-income communities."
Steven L. Dawson

Bronx, Feb. 9, 2011
Stephen L. Dawson is president of PHI, which works to improve the lives of people who need long-term services and the lives of people who provide that care.

Editors Commentary: While I agree with Mr. Dawson, we have known these labor shortages would exist for at least 25 years. In 1985, as President Reagan began his second term, the U.S had at least 76 million citizens who were about to enter their 40's. An abundance of research had already been published that average life spans were going to be in the 70's and even past age 85.

Is it any surprise then that these tens of millions of 40 year olds in 1985 would be reaching retirement age in 2010 and would very likely need alot of old age care in 2030. Suddenly elected officials in both major political parties, not to mention the "Tea Party" are all trying to shout each other down, insisting that "We have to do something about entitlements" like Medicare and Social Security, not to mention Medicaid nursing home costs which are the largest single item in every state's budget.

Since we all have known this was coming for at least a quarter century, does anyone really believe that there is any other solution besides draconian budget cuts and a steep rise in taxes? If you do please let me know.
Bob O'Toole
Editor
bob@elderlifeplanning.com

Look at the Facts Before Trashing Obama Health Care Reform

2011-02-09T16:33:00.000-05:00

Despite having the most costly health system in the world, the United States consistently underperforms on most dimensions of performance, relative to other countries.

According to the Commonwealth Fund, a private foundation that aims to promote a high performing health care system the United States ranked last when compared to six other countries -- Britain, Canada, Germany, Netherlands, Australia and New Zealand, the Commonwealth Fund report found.
This report—an update to three earlier editions—includes data from seven countries and incorporates patients' and physicians' survey results on care experiences and ratings on dimensions of care. Compared with these six other nations the U.S. health care system ranks last or next-to-last on five dimensions of a high performance health system: quality, access, efficiency, equity, and healthy lives. Newly enacted health reform legislation in the U.S. will start to address these problems by extending coverage to those without and helping to close gaps in coverage—leading to improved disease management, care coordination, and better outcomes over time.

The U.S. health system is the most expensive in the world
United States underperforms relative to other countries on most dimensions of performance.
Among the seven nations studied—Australia, Canada, Germany, the Netherlands, New Zealand, the United Kingdom, and the United States—the U.S. ranks last overall, as it did in the 2007, 2006, and 2004 editions.
The most notable way the U.S. differs from other countries is the absence of universal health insurance coverage.
Health reform legislation recently signed into law by President Barack Obama should begin to improve the affordability of insurance and access to care when fully implemented in 2014.
Other nations ensure the accessibility of care through universal health insurance systems and through better ties between patients and the physician practices that serve as their long-term "medical homes."
Without reform, it is not surprising that the U.S. currently underperforms relative to other countries on measures of access to care and equity in health care between populations with above-average and below-average incomes.
The Patient Protection and Affordable Care Act of 2010 also will work toward realigning providers' financial incentives, encouraging more efficient organization and delivery of health care, and investing in preventive and population health.

For all countries, responses indicate room for improvement. Yet, the other six countries spend considerably less on health care per person and as a percent of gross domestic product than does the United States. These findings indicate that, from the perspectives of both physicians and patients, the U.S. health care system could do much better in achieving value for the nation's substantial investment in health.

To read the full report go to this link: http://www.commonwealthfund.org/Content/Publications/Fund-Reports/2010/Jun/Mirror-Mirror-Update.aspx.

ABC Nightly News Series Last Week About Family Caregivers "Families on the Brink".

2011-02-05T14:07:00.000-05:00

Here is a link to the 5 segments that ran on ABC Nightly News last week entitled "Families on the Brink".

If you are among the more than 30 million Americans involved in some way as a family caregiver and are feeling overwhelmed by the responsibility at times, I think you'll find this series of 5 minute videos to be very informative.
http://abcnews.go.com/WNT/video/families-brink-family-tension-12806181&tab=9482930&section=1206853&playlist=1363488

Severity of Budget Cuts Increases Caregiving Pressure on Family Members

2011-02-01T17:38:00.000-05:00

California’s program for adult day health care centers is a boon to families, allowing them to leave their loved ones in the care of medical professionals while taking much-needed respite to run errands or go to work.

But that benefit could come to an end if proposed budget cuts are carried out to help reverse the state's $28 billion deficit.

According to an article in the San Francisco Chronicle(January 29, 2011), nearly 37,000 frail or disabled seniors on Medi-Cal , California’s Medicaid program for those who can’t afford to pay for needed care, use these care centers every month. Without funding, the centers are expected to close, meaning that families would have to shoulder the burden of caring for their sick alone or put them in a nursing home, where their care would be more expensive for the state.

Deep cuts to programs that provide care to frail elders is a nationwide problem. In this video, more than a dozen groups who serve or advocate on behalf of frail elders and family caregivers, held a candlelight vigil at the state capital in November to protest steep cuts to that state’s publicly funded elder services including ending in-home care for 2,000 elderly.

The $419 million cost of California's program in fiscal year 2010 was split evenly between state funds and federal matching dollars.

Cuts to care for the vulnerable in Gov. Jerry Brown's proposed budget don't end there. The state wants to reduce in-home support services for 440,000 low-income seniors and disabled people, to save $500 million.

The state also is proposing to cap Medi-Cal benefits, such as hearing aids, medical equipment and doctors' visits. Medi-Cal recipients would be limited to 10 doctors' visits a year, with a $5 office visit co-pay and a $50 emergency room co-pay.

The state's director of health care services Toby Douglas said the day care program allows seniors to remain in their communities, but it is optional under Medicaid — known as Medi-Cal in California — and only eight other states pay for the benefit.

http://Elderplanner.skrawlr.com

2011-02-01T16:21:00.000-05:00

http://elderplanner.skrawlr.com/

Cornell University Study: Elder Abuse Is More Prevalent Than Previously Thought

2011-01-24T15:49:00.001-05:00

Financial Exploitation Found to be the Most Prevalent Form of Elder Mistreatment.

A new study has found alarming rates of undetected elder abuse, neglect and exploitation. Although limited to New York State, the study suggests that elder abuse is far more prevalent than was previously known. For example, the study found that for all types of elder abuse, there are 23.5 unreported cases to every one reported to any agency.

Researchers conducted random telephone surveys of 4,000 New York residents 60 years and older, and compared the occurrence of elder abuse uncovered by the surveys to the numbers of cases reported to adult protective services, law enforcement and other officials or providers. In the case of financial exploitation, the study found 43.9 self-reported cases to every one reported to an agency. The ratio of neglect cases was even higher, with 57.2 cases going unreported for every one that comes to the attention of any services system. A previous study reported by ElderLawAnswers found that for each case of abuse reported, there are at least four that go unreported.

The National Adult Protective Services Association, http://www.apsnetwork.org/ which is publicizing the study's results, said that the actual prevalence of elder abuse in the total older population may be even higher because the study did not include older persons unable to participate in a telephone survey.

Interestingly, while emotional abuse is the most common form of elder abuse reported to agencies, followed by physical abuse, the self-reported study found financial exploitation to be the most prevalent form of elder mistreatment.

The Association, which represents Adult Protective Services professionals, said that the findings "underscore the urgent need for Congress to appropriate funding for the Elder Justice Act, the first and only comprehensive federal law addressing elder abuse. The Act authorizes up to $100 million in funding per year for state and local Adult Protective Services (APS) Programs, which could provide an estimated 1,700 protective services investigators throughout the country. As the number of seniors, and in particular the number of cases of financial exploitation, rises exponentially, APS Programs throughout the country are being slashed because of faltering state budgets, severely compromising their ability to investigate elder abuse and to take measures to protect frail, often extremely vulnerable older victims."

The Association notes that older persons, as well as younger adults with disabilities, who are victimized by violence, neglect and exploitation are the only category of crime victims who receive no dedicated help from the federal government. The Elder Justice Act was enacted as part of the health reform legislation, but Congress has not funded it.

The New York State Elder Abuse Prevalence Study is the second-largest study ever conducted on the prevalence of elder abuse and the first statewide study to compare self-reported data to reported case data over the same time period. The study's contents are not yet available, pending release by New York State Office of Children and Family Services. The study's authors presented their results at a recent conference on aging.

Nursing Home Has License Suspended After Family Uses Hidden Camera to Expose Patient Abuse

2011-01-20T08:32:00.002-05:00

Sacramento Television station KXTV, reported that Fair Oaks, CA elder care home was closed last week after the California Department of Social Services temporary suspended its license because of allegations staffers abused residents in their care.

Relatives of a patient said they started looking into patient care at the home after her death which court records show was caused in part by an overdose of a prescription pain killer which had never been prescribed to this patient.

Even before her death, family members said they were growing suspicious. They installed a hidden camera into the patient's private room, which eventually caught what they call clear signs of abuse. The video shows workers putting their family member into a wheelchair, tipping her back and then shaking her.

The state department that oversees eldercare facilities alleges the staffers of the Fair Oaks facility abused other patients and violated numerous regulations, including altering the expiration dates on prescriptions.
Other alleged violations include positioning patients upside down in wheelchairs, leaving them unattended for hours, and ignoring them after a fall.

The temporary closure order went into effect on Thursday, Jan. 13 at 5 p.m. The home transferred its patients to other facilities. State records show the facility can hold 15 residents.

Owner Myoung Kim refused to address the allegations when she spoke to News10 briefly Thursday a few hours before the home was shut down. "I don't know until I talk to my lawyer," Kim said.
Source: News10/KXTV
Copyright 2011 / All Rights Reserved

Here are some of the responses from those

who viewed this storyJrsfan wrote:

"It is stories like this one that make me so affraid to have to put my dad somewhere if or when that time comes. My daughter wants him to come live with her but because of his asthma he cant live in sac. I may just have to move to so cal and take of him. And I will do that in order to keep him from being treated like this, shame on these people. Prayers to the Duncan family"

nonayerbiznaz wrote:
"Other alleged violations include positioning patients upside down in wheelchairs, leaving them unattended for hours, and ignoring them after a fall."
I'm trying to picture someone upside down in a wheelchair....I hope to God ...all other accomplices go to prison ad never get the oppurtunity to do any type of care in the future. Sickening!

ShellShocker wrote:
As a person who is taking care of an elderly mother I feel so sorry for this family. Smart move putting the video camera in as without it there would never be a case.

Our Blog Posts on Wall Street Exploitation of Nursing Home Patients in 2007 and 2008 Prove Prophetic

2011-01-12T18:05:00.002-05:00

In a posting to this blog on October 9, 2007 in this blog, we highlighted a NY Times article that revealed how Wall Street private equity firms had bought thousands of nursing homes and used complicated corporate structures to avoid liability when residents suffered from neglect.

Now another study, just released last week confirms that the nursing home industry continues to decline, with the biggest impact felt by America's poorest communities. (See the post below this one also with today's date)

"The homes often cut expenses and staff, sometimes below minimum legal requirements, to increase profit." the Times reported. "These private-equity firms are unregulated and new to the nursing home market."
"Many worry that the top priority for these new owners will be profits, rather than providing the staffing and resources necessary to ensure top quality care for our loved ones. Private for-profits do have a wider range of behaviors than public for-profits. A private equity group can be more ruthless about profit than a public company."

Frequently, they use complex corporate structures, separating the nursing home real estate from the operating companies and putting multiple layers of limited liability partnerships between themselves and the day-to-day operations of the nursing home.

"The Carlyle Group, already planned to restructure its take-over of Manor Care, which will comprise about 300 corporate entities that could obscure ownership and make it more difficult to regulate care." according to the Times.

The times article revealed that wealthy and powerful private investors set up "ownership structures with multiple stakeholders ...have been to minimize liabilities and shield them from regulator inquiries like when cutting staff is made to improve profit margins. They use these kinds of structures to avoid taking responsibility when taking control of nursing homes."

The Times listed among The Carlyle Group's roster of key players two former U. Presidents, George W. Bush, who served as a director from 1990 until he ran for Governor of Texas in 1992, and his father former U.S. President George H. W. Bush, who was a Senior Advisor to the Carlyle Asia Advisory Board from April 1998 to October 2003 James Baker III, who served in major roles in both President Reagan and
G.H.W Bush administrations was a Carlyle Senior Counselor from 1993 to 2005, according to the times report.

Other power brokers closely associated with the Carlyle Group inlude Frank C. Carlucci, Secretary of Defense during the Reagan administration served as Carlyle Chairman and Chairman Emeritus from 1989 to 2005 and Arthur Levitt, Chairman of the U.S. Securities and Exchange Commission (SEC) under President Bill Clinton, has been a Carlyle Senior Advisor.

According to the Times, "The thinly disguised intention of these Wall Street firms was to drain as much profit for their investors at the expense of frail and vulnerable nursing home residents and then have the corporation that owned the nursing home declare bankruptcy leaving the financially gutted nursing facilities in the lap of already financially strapped state governments."

The subcommittee released a report commissioned by the Centers for Medicare and Medicaid (CMS) that suggested that the regulatory enforcement system for nursing homes has a lot of problems.

The NY Times article can be found at www.nytimes.com/2007/10/24/.../24retirement.html

The Washington Post also reported on investigations into the Carlyle Group for their exploitation of U.S. nursing homes: http://www.washingtonpost.com/wp-dyn/content/article/2008/02/14/AR2008021403573.html

In Part 2 of our postings on this issue, (October 4, 2008) we posted an article in the NY Timesthat reported that "Inspectors Received 7,150 Complaints About Conditions in Nursing Homes Last Year. "

Among other things the Times article reported that "more than 90 percent of nursing homes were cited for violations of federal health and safety standards last year, and for-profit homes were more likely to have problems than other types of nursing homes. About 17 percent of nursing homes had deficiencies that caused “actual harm or immediate jeopardy” to patients, said the report, by Daniel R. Levinson, the inspector general of the Department of Health and Human Services. "

"Problems included infected bedsores, medication mix-ups, poor nutrition, and abuse and neglect of patients.
Inspectors received 37,150 complaints about conditions in nursing homes" in 2008, the times stated "and {inspectors} substantiated 39 percent of them, the report said. About one-fifth of the complaints verified by federal and state authorities involved the abuse or neglect of patients. About two-thirds of nursing homes are owned by for-profit companies, while 27 percent are owned by nonprofit organizations and 6 percent by government entities, the report said. "

"While for profit homes were the most flagrant violators of patient care regulations, the problem is truly industry wide with non-profit homes and government owned facilities performing poorly-just not as badly as the for profit homes. The inspector general said 94 percent of for-profit nursing homes were cited for deficiencies last year, compared with 88 percent of nonprofit homes and 91 percent of government homes. "
Part 2 can be found by putting the words "Imminent clollapse" in the search box and clicking on the magfnifying glass or you can paste this URL into your browser:

http://elderplanner.blogspot.com/search?updated-min=2008-01-01T00%3A00%3A00-05%3A00&updated-max=2009-01-01T00%3A00%3A00-05%3A00&max-results=50

Nursing Home Closings Continue to Rise. "Only the Wealthy Will have Access to Nursing Homes"

2011-01-12T16:57:00.002-05:00

U.S. Nursing Home Closings Hit Poor The Hardest
By Alan Mozes HealthDay Reporter

Jan. 10 (HealthDay News) -- Widespread nursing home closures over the past decade have resulted in a 5% drop in available nursing home beds across the United States, with poor, urban neighborhoods hardest hit, new research reveals.

"The country's minority population is aging at a steeper rate compared with the white population," according to a study from the Center for Gerontology and Health Care Research at Brown University in Providence, R.I. Ahis is occuring at a time when the need for long-term care is rising fastest in minority communities, even as nursing home closings are happening more often in their areas.

The findings are published in the Jan. 10 online edition and the May 9 print issue of the Archives of Internal Medicine.

These closings represented a loss of 16% of all Medicare/Medicaid-certified nursing homes and nearly 97,000 -- or more than 5% -- of nursing home beds.

The team concluded that nursing homes in minority and low-income communities are bearing the lion's share of financial pressures and closures, which raises concerns about rapidly diminishing senior care options and the quality of the remaining facilities in those places.

People in low-income neighborhoods who use nursing homes are Medicaid recipients, whose reimbursement rates are lower than the fees of private-pay patients. "So the result is that those places that care for these patients are more likely to close," he said.

More than 27 million Americans will need long-term care by 2050, nearly twice as many as in 2000
The study's authors concluded that "only the wealthy will have access to nursing homes"

"What? You have a C grade from Better Business Bureau ? No problem, just pay us $500 for a membership and we’ll bump it up to A+"

2011-01-05T10:58:00.000-05:00

An estimated 80 percent of American consumers recognize the Better Business Bureau brand. Most consumers assume that if a business is rated "A" by the BBB it must be a reliable and high quality enterprise.

Coversely, an "F" grade by the Bureau must mean that company must be doing a lousy job for it's customers and consumers should stay away.

Many providers of eldercare services pay membership fees to the BBB in hopes of adding credibility to the company and attract more customersw.

In a survey conducted by CredentialedCARE Corporation, CredentialedCARE Corporation, which operates the Web site, CredentialedCARE.com, where health care employers can perform employment verification checks on prospective employees in a survey of home care providers, found that 22% of home care agencies were found to use Better Business Bureau accreditation to promote their business.

In November 2010 ABC News exposed the Better Business Bureau as an organization as being a self-serving, biased judge of business character that is heavily influenced by the fees it collects from its membership. BBB gives high grades to businesses that pay them a membership fee and often gives "F" grades to companies who refuse to pay these fees. For example, well respected companies such as Wolfgang Puck's and Hilton Hotels were given "F" grades while the terrorist group Hamas and a white supremacy group who paid BBB's fees, received "A" grades.

To view the 20/20 segment exposing BBB's practices, and the enormous salaries paid to their senior executives paste this link into your browser:
http://abcnews.go.com/2020/video/business-bureau-probe-12138262?tab=9482930§ion=1206863&playlist=12138766&page=1

Jimmie Rivers is the pen name of an Emmy nominated, former CBS affiliate news director in a top 20 market. He also served as publisher of an investigative journal that was the state's largest paid circulation magazine. For several years he worked for one of the nation's highest profile advertising agencies.

Rivers has set up a web site focused on exposing the abusive and misleading practices of the Better Business bureau. You can find his site at the following link: http://www.bbbroundup.com/AboutUs.html

Seattle Times Exposes Kickbacks Paid to Agencies Offering Caregivers "Free" Services"

2010-12-15T15:48:00.000-05:00

The Seattle Times has published an expose of a huge and growing business that offers to help families find care for aging relatives at no charge.

One such company "A Place for Mom" a Seattle based company is the nation's largest placement service, spanning 45 states with 450 referral brokers in home offices. Nationally, it has contracts with 18,000 eldercare facilities. Financial analysts estimate the private company pulls in $50 million a year.

Behind this digital-era juggernaut is John Temple, a former Microsoft manager; his wife, Pamala, an experienced long-term-care executive; and entrepreneur Brian Trisler, a college friend.

The company's website attracts more than 60,000 visitors a month and instantly prompts them for contact information. Within 15 minutes, that information is routed to an employee, called an eldercare adviser, who quickly calls and gathers more information, Pamala Temple said.

Advisers provide seniors with a list of referrals to half a dozen or more adult homes, including information about costs and services. In turn, advisers send information about the seniors to adult homes. If a placement results, A Place for Mom collects a commission, with about $650 going to the adviser, company records show.

A Place for Mom generally does not meet face to face with families, according to the Times, or take them on tours. Seniors and their families are responsible for visiting the homes themselves.

The paper reports that "a dozen Washington families told The Times that A Place for Mom guided them to homes where caregivers said the company had not visited in years or not at all.

"The company does not routinely check to see whether the home has a history of violations" according to the article. As a result, A Place for Mom has on its referral list dozens of homes with histories of substandard care, including homes currently on probation for abuse or neglect violations, The Times found.

For example, the company listed a Tacoma adult family home, Narrows View Manor, which has been cited with more serious violations than any other home, including fatal neglect.

This is a brief excerpt of an extensive expose on these abusive practices. To read the complete article go to the following link: http://seattletimes.nwsource.com/html/localnews/2013650485_seniors12.html

This Blog Has Been Nominated for An Award

2010-12-02T17:49:00.002-05:00

South Korea Coping with "Epidemic" of Alzheimer's Disease

2010-12-01T17:09:00.000-05:00

The New York Times has one of the most informative blogs I have found- and I follow alot of them-on the subject of Alzheimer's disease, it's impact on patients, caregivers and on society as a whole.

The Times puts their significant pool of journalistic resources to the task of continually providing updates on the challenge of finding better treatments and, hopefully, someday finding a cure for this disease.

While the primary focus of this blog is manpower shortgages and financing issues related to long-term care in the U.S., the Times has done a great job in reminding their readers that Alzheimer's is a world wide epidemic. In fact there are several countries that have older populations and a much greater incidence of Alzheimer's Disease. Today there are about 30 million estimated cases world wide today (5.5 million in the U.S.). This number is expected to grow to an estimated 100 million in 2050.

You can follow their ongoing coverage by bookmarking the nfollowing link http://newoldage.blogs.nytimes.com/2010/11/26/a-war-on-dementia/

Late last month the Times reported on a remarkable South Korean campaign to cope with an exploding problem: South Korea is one of the world’s fastest-aging countries, with nearly 9 percent of its population over 65 already afflicted with Alzheimer's. The South Korean government is acting in a much more proactive and coordinated way than the U.S. in addressing this issue head on.

The country is training thousands of people, including children, as “dementia supporters,” to recognize symptoms and care for patients. The 11- to 13-year-olds, for instance, are in the government’s Dementia Experience Center, “Aging-Friendly Comprehensive Experience Hall” outside Seoul to learn perform hand massage in nursing homes.

Hundreds of neighborhood dementia diagnostic centers have been created. Nursing homes have nearly tripled since 2008. Other dementia programs, providing day care and home care, have increased fivefold since 2008, to nearly 20,000. Care is heavily subsidized.

To finance this, South Korea created a long-term-care insurance system, paid for with 6.6 percent increases in people’s national health insurance premiums. In 2009, about $1 billion of government and public insurance money was spent on dementia patients. Still, with the over-65 population jumping from 7 percent in 2000 to 14 percent in 2018 to 20 percent in 2026, dementia is straining the country, socially and economically.
“At least one family member has to give up work” to provide caregiving, said Kwak Young-soon, social welfare director for Mapo District, one of Seoul’s 25 geographic districts. Because South Korea encourages people to work well past retirement age, families may also lose dementia sufferers’ incomes.

Most families no longer have generations living together to help with caregiving, and some facilities have long waiting lists, but “we can’t keep building nursing homes,” Mr. Kwak said. “We call it a ghost. It’s basically eating up the whole house.”

Facing Death,” an hour-long Frontline Documentary is "Must see TV on PBS

2010-11-23T18:18:00.000-05:00

Tonight Tuesday Nov 22, 2010 and on other nights this week-check your local PBS listing or go to http://www.pbs.org/wgbh/pages/frontline/facing-death/etc/readings-links.html

“Facing Death,” an hour-long “Frontline” documentary will be airing on PBS Tuesday.
You will also be able to watch it on line
This clear-eyed look at dying patients, surrounded by their bewildered and conflicted families in the intensive care unit at New York’s Mount Sinai Medical Center, carefully avoids taking a position on what we’ve euphemistically come to call end-of-life care.

The program offers very intimate portraits of patients and families grappling with the tough decisions about how much treatment is too much when the prognosis is grim. Meanwhile, their doctors explain to us, the viewers, that medical advances have made those judgments even more difficult than they always were.
http://www.pbs.org/wgbh/pages/frontline/facing-death/etc/readings-links.html

Take the Federal Budget Tour: 10 Simple Slides to Better Understand Deficits and Debt

2010-11-21T20:46:00.000-05:00

The State of the USA Take the Federal Budget Tour

Did you know that you're share of the debt is $40,000?
Bob O'Toole
http://www.youragingparents.net

Conservative Texas Lawmakers Want State to Drop Out of Medicaid Alleviate $25 billion Shortfall.

2010-11-09T17:52:00.000-05:00

Suzy Khimm, writing in A Washington Post blog Claims that several states are considering drastic cuts or even elimination of the Medicaid health insurance program for the poor http://voices.washingtonpost.com/ezra-klein/2010/11/what_if_states_ditch_medicaid.html

"Many GOP state governments, along with a handful of Democratic ones, have complained that the expansion will bankrupt already cash-strapped budgets." Kim reports
Texas, however, has taken such protestations a step further. Conservative state lawmakers are now demanding that the state drop out of the program altogether to alleviate the state's $25 billion shortfall. If Texas went ahead with such a plan, it's unlikely that the Medicaid program would entirely disappear, but its reimbursement rates would fall so low without state support that almost no one provider would accept the coverage."
"The underlying rationale is that sacrificing the health coverage of poor people would be a worthwhile move if it solves the state's budget crisis. If you're a purist in opposing the welfare state — even at significant human cost to the most vulnerable — it's a logical argument to make."

Texas already has the highest proportion of uninsured residents in the nation, at 27 percent. If the state dropped Medicaid, that would go up to 40 percent.

"My name is Norrm and at 50 years old I was diagnosed with Alzheimer’s"

2010-11-08T15:50:00.002-05:00

I received the following e-mail message from a remarkable man from England, Norman McNamara, who was diagnosed with "early onset" Alzheimer's disease 3 years ago. I had read about a man who was publishing a newsletter about how it feels to have this disease-from someone who is actually living with it. I found the newsletter and became a subscriber and we've been corresponding lately.

In my more than 25 years in the field of aging, including teaching gerontology at the college level for 10 years, I have read numerous books and articles about this disease, many of which were written by some of the leading neuroscientists conducting research on Alzheimer's and related brain disorders normally found in those who elderly.

Last year our company managed a 20 city pilot program known as the CAREPAC program (Community Alzheimer's Research Education for Patients and Caregivers) using our nationwide network of geriatric care managers and home care agencies to raise awareness of Alzheimer's clinical trials and providing caregiver support services to trial participants and family caregivers to improve the retention rate of trial participants.

We are now developing a more extensive clinical trial awareness and supportive services program for clinical trials related to diseases of aging that will be available nationwide this fall.

But this is the first time I have had the opportunity to correspond with someone who is actually living with this disease. His spirit, his outlook on life in the face of adversity and his determination to help others with the disease is very inspiring to me.

With his permission I now invite you to read a perspective on Alzheimer's disease that most of us have never been exposed to.

"Hello Robert and thank you for your friendship. My name is Norrms and at 50years old I was diagnosed with Alzheimer’s, I am now 53yrs old and I have every intention of beating it. I have contacted you to hopefully try to help you understand what its like being an Alzheimer’s sufferer and how it feels to be diagnosed with such an awful disease."
"All I want to do is to give hope to sufferers and try to give caregivers and professionals alike a better understanding of this awful disease. I just want to do as much as I can for as long as I can, as I am a realist and I know what my future holds unless they find a cure."
Best wishes, Norrms and family xxxxxxxxxxx

You will find a video made about Norms' BBC interview
http://www.youtube.com/watch?v=aWTkWACwFWw

(Me and My Alzheimer’s) http://i-proclaimbookstore.com/meandmyal.html The link to my books are
For last couple of years I have been raising awareness and I have appeared on BBC Radio Devon and BBC Southwest TV

Also on the BBC website is http://news.bbc.co.uk/local/devon/hi/people_and_places/newsid_9073000/9073863.stm

"More than words, poems written and spoken by an Alzheimer’s sufferer"

Please visit my blog and I hope it helps, my blog is blog is http://norrms.web.officelive.com/default.aspx
With your permission these are two books I have written, one called "Me and My Alzheimer’s" and one called "More Than Words, poems written and spoken by an Alzheimer’s sufferer" which i have wrote since being diagnosed with early onset Alzheimer’s" A good percentage of the sales will be donated to the Alzheimer’s Society.

NFL players Are 19 Times More Likely to have Dementia Than The General Population

2010-10-30T15:16:00.000-04:00

Bostonia, The Alumni Magazine of Boston University where I did my graduate work, has a disturbing article in it’s current issue (Fall 2010) that I hope will get widespread attention. Despite a common misconception that professional football players are “physically fit”, the fact is, these athletes have a shockingly short life span at a time when the general population is longer than ever before.

As far back as 1994 the National Institute of Occupational Safety and Health found that NFL linemen had a 52 percent greater risk of dying from heart disease than the general population. While U.S. life expectancy is 77.6 years, recent studies suggest the average for NFL players is 55 and age 52 for linemen.
National Football League linebacker John Grimsley played nine years for the Houston Oilers and absorbed at least 11 concussions during professional and college play. In February 2008, Grimsley, an outdoorsman fatally shot himself in the chest while cleaning his firearm. He was 45 years old. In the years leading up to his death, Grimsley had changed. He became forgetful and scattered, quick to anger.

A week after Grimsley’s death, Ann McKee, a Boston university School of Medicine associate professor of neurology and pathology examined brain cells from the former NFL linebacker. When McKee looked at his brain, she found evidence of chronic traumatic encephalopathy (CTE).

In early October 2009, as BU’s School of Medicine was gearing up to host a conference on athletes and concussion at Gillette Stadium, in Foxboro, Mass., home of the New England Patriots, the results of a long-touted study commissioned by the NFL had leaked to the media.
• The research showed the prevalence of dementia, Alzheimer’s, or other memory-related diseases among retired NFL players 19 times higher than in the general population.

“When I showed the results to my brother, who is also a doctor and played football, he said, ‘You’re going to ruin football,’” recalls McKee, .
McKee, a diehard Green Bay Packers fan, has done extensive studies along her colleagues at BU’s Center for the Study of Traumatic Encephalopathy (CSTE) and with Dr. Robert Stern, associate professor of neurology and co-director of BU’s Alzheimer’s Disease Clinical and Research Program.

These Boston University researchers work closely with the Sports Legacy Institute to advance the study, treatment and prevention of the effects of brain trauma in athletes and other at-risk groups military veterans and the millions of kids who strap on helmets and pads and emulate their idols.

“What BU brought to the table was an explanation for some of the bizarre behavior we’d seen in a number of players whose lives were cut short, many because of suicide or what were thought to be accidental injuries,” says Kevin Guskiewicz, chair of the exercise and sport science department at the University of North Carolina and author of a 2003 study linking concussions in retired NFL players to clinical depression.

For years, the NFL downplayed the link between head blows on the field and brain damage later in life. The league’s medical advisor had this to say about Guskiewicz’s 2003 findings: “When I look at that study, I don’t believe it.”

Researcher Ann McKee was invited to discuss her findings with the NFL. “They were polite,” she says. “But it was falling on deaf ears.”

Finally in the middle of the 2009–2010 NFL season, the $8 billion-a-year industry appeared to run a single reverse. It publicly acknowledged the link to dementia and instituted return-to-play rules that forced a newly concussed player to sit out the rest of a game or practice and required an OK from an independent neurological expert before he could return to the field.

Christopher Nowinski, A Harvard graduate who played defesive tackle on that school’s football team was forced to retire at age 24 with post-concussion syndrome. He once trashed a hotel room in his sleep after a concussion. He published the book “Head Games: Football’s Concussion Crisis from the NFL to Youth Leagues”. It was Nowinski, along with Robert Cantu, a professor of neurosurgery, who wrote the original—and largely ignored—return-to-play guidelines in the 1980s that formed the Sports Legacy Institute. In 2009, McKee found still more evidence of CTE including an 18-year-old high school football player who had suffered multiple concussions.

One in eight boys under 18 in this country play the some form of organized football. These kids see professional football players as role models and do what they do on the field. It is tragic enough that we are still a long way from finding a cure or even an effective treatment for Alzheimer’s disease, which affects more than 5.5 million Americans. If serious steps are not taken now, to address the serious risk of CTE faced by these kids, we will only compound this tragedy.

For the complete article in Bostonia along with links to still more information about the long term effects of concussions in football players and other athletes go to http://www.bu.edu/bostonia/fall10/football/

Bob O'Toole, the Editor of this blog can be reached at bob@elderlifeplanning.com

Nursing home and assisted living rates rose significantly from 2009 to 2010

2010-10-27T17:50:00.000-04:00

The story we've been tracking on this blog for more than two years now, continues to get worse.

The costs of providing care for frail elders who need assistance every day with their activities of daily living continue to rise in the face of shrinking public and private dollars to pay them.

Nursing home and assisted living rates rose significantly from 2009 to 2010, according to the Market Survey of Long-Term Care Costs. Private room nursing home rates rose 4.6% to $229 per day or $83,585 per year, while assisted living rose 5.2% on average to $3,293 per month, or $39,516 per year. These increases come on top of increases from 2008 to 2009 when both nursing home and assisted living costs were up 3.3%.

Costs for home health aides and adult day services were unchanged in the past year. Home health aide costs remain at an average price of $21 per hour, while adult day services costs are still $67 per day.
The highest average daily rates for nursing homes continued to be in Alaska, where rates are now $687 for a private room and $610 for a semi-private room. Costs are lowest in Louisiana, outside the Baton Rouge and Shreveport Metropolitan Statistical Areas (MSA), at an average of $138 per day for a private room.

For assisted living, the Washington, D.C. area had the highest average monthly base rate at $5,231, while Arkansas, outside of the Little Rock MSA, had the lowest average monthly rate of $2,073.

For a free download of the full report go to http://www.metlife.com/mmi/?WT.mc_id=vu1243

New Technologies Will Help More Older Americans Remain at Home

2010-10-25T13:28:00.000-04:00

New Technologies Will Make It Possible for a Larger Segment of Frail Elders to Avoid or Delay Placement in an Institutional Care Setting

By Bob O’Toole
We’ve all seen the endless replaying of the commercials for home safety alert devices “I’ve fallen and I can’t get up” and other variations on this theme. These “medical alert systems” are also referred to as “Personal Emergency Response Systems” (PERS).
There are several kinds of home medical alert alarm systems. The most common type is designed for users to push the button of a pendant that can be worn around the neck, (or in some cases a wrist band) alerting a call center that the user needs help.
Typically the operators have a list of who to call in case of an emergency, such as family members or nearby neighbors, as well as calling 911 if it appears that the caller in distress may require medical attention. While you might want to consider this type of alarm, you should also be open to a new generation of alarm systems. Some systems will work better than others, and this is mainly based on the quality of the system, reliability of the monitoring company (if monitoring is part of the package) and appropriateness of the system's installation in the home.
In recent years, there have been so many products of this type that consumers need to use caution before buying or leasing a home safety alert system. The web site http://elderlymedicalalertsystems.com/ claims to provide unbiased information to help consumers choose from among the many medical alert systems out there. This web site helps you to become a better informed consumer by answering the following questions:

What do medical alert systems do?

What are the different designs available?

What is best for you?

Where should you purchase?

According to http://elderlymedicalalertsystems.com/ Most of the equipment that’s out there is perfectly good. There are a few different types of systems, some that call out and provide one-way communication, others that provide two-way communication, and still others that allow you to talk through the pendant instead of through the base station. You can find out all about these options on their website.
“So you’re not really dealing with a quality difference in the equipment if you’re comparing the same kind of equipment from two different manufacturers. What you are comparing is the service environment and if you have a monitoring solution, the quality of the monitoring. The way the sales person treats you is a good indication of the corporate culture of the company and may give you a hint as to how you’ll be treated if you need customer service or when you have an emergency.”

In the last few years, a series of technological developments has given consumers some new options. Devices and Internet-based solutions are becoming available that allow caregivers to keep an unobtrusive, high-tech eye on their family members, ensuring that they’re safe, healthy and well cared for.
The impact of these home based technologies and many others that are under development on both the “Who Will Care?” and “Who Will Pay?” questions will be significant. In many cases elders who are frail and may be at risk if they stay at home without assistance, will be able to remain in their home longer if they use reliable monitoring equipment. One reason is that the cost of these devices compared with the hourly rates of nurse’s aides and personal care attendants is significantly less.
While they may never completely replace the human touch of a caring home health aide to assist with bathing, dressing and other hands on care, the number of hours of the aide may be sharply reduced, thus making the use of home care aides combined with high tech aides more affordable to a much larger segment of those with limited financial means.
“If an individual can be safe at home, family relationships are enhanced and costs are reduced,” said William Kaiser, a director of the U.C.L.A. Wireless Health Institute, a research group that examines the intersection of technology and health care. “New technologies are creating a revolution in the ability of individuals to stay at home,” he added. “The benefits to society are profound.”

BABY BOOMERS WON'T BE GETTING "the largest wealth transfer in history"

2010-09-29T19:54:00.000-04:00

"The largest wealth transfer in history"?

A study by Cornell University researchers in 1989, famously predicted that boomers would inherit $10.4 trillion.

A decade later, a report "Millionaires and the Millennium: New Estimates of the Forthcoming Wealth Transfer and the Prospects for a Golden Age of Philanthropy", published by researchers at Boston College was much more grandiose. This study predicted when the parents of the baby boom generation (generally considered to be those who were born between 1946 and 1964), died, they would leave behind a total of $41 trillion of accumulated wealth to their offspring.
But don't start planning on that big inheritance warns Brenda Wenning, an investment advisor in Massachusetts. Wenning, in an article in the The MetroWest Daily, a newspaper that covers many of the affluent suburban communities near Boston, warned baby boomers not to plan on what some “experts’ were predicting would be "the largest wealth transfer in history".
“... it appears that the reality will be far more modest’, writes Wenning. “Parents of boomers are living longer, their health care costs are more expensive than predicted and they’ve also suffered through the same bear markets as their children. Their inheritance, in many cases, is gone - and they may even be relying on their children for help.”

Liz Pulliam Weston, a writer for MSN Money, said of these wealth transfer predictions, “If you think that sounds too good to be true, youre right.”

“Counting on an inheritance as part of your financial plan, says Pulliam "is, unfortunately, about as smart as depending on a lottery ticket.”

A recent study by the American Association of Retired Persons (AARP) found that only about one in five boomer households has received an inheritance and only 15 percent of remaining boomers still expect to receive one. Of those who received an inheritance, the median value has been about $64,000 – “nice to have, says Pulliam,”but not enough to sustain another generation during retirement.”

This week's Census Bureau report I cited in yesterdays posting says pretty much the same thing. A very small percentage of middle aged Americans will inherit alot of money, while the overwhelming majority will more likely need to dig into their own pockets to help pay for their parents care.

According to the Metlife Mature Market Institute, many of today’s boomers have parents receiving long-term care and it’s costing, on average, $72,270 a year. Long-term care is not covered by health insurance, Medicare or any other government program, so most baby boomers will have to use their personal savings to pay for long-term care.

The National Clearinghouse for Long-Term Care Information estimates that 70 percent of people over age 65 today will need long-term care services. If baby boomers live longer that today’s seniors, the percentage needing long-term care may be even higher.

Social Security. Social Security is a pay-as-you go system, meaning that the money you have been paying into the system throughout your working life is paying for someone else’s retirement.

When boomers retire, a greater percentage of the population will be retired and a smaller percentage will be working. That means fewer people will be paying to fund Social Security for a much larger population of retirees.

In addition, when people live longer, they collect Social Security for a longer period and that puts further pressure on the system. When Social Security was created, retirement typically lasted only a few years.

This is, unfortunately, an almost unavoidable economic train wreck. But it's hardly a surprise. As far back as the mid 1980's, during the administration of President Reagan, our elected leaders did something that is almost unimagineable today. The Republican President and then House Majority Leader, Democrat Thomas P. "Tip" O'Neil sat down with members of both parties and worked out a bi-partisan agreement, to implement changes in the Social Security System. 25 years ago they locked the Ph.D's out of the room and did some simple 5th grade arithmetic. Without even using a calculator they figured out that if their were 76 million 40 year olds then, there was a pretty good chance that these very same Americans would be 65 years old 25 years hence.

So they made some modest changes, that became the "Social Security Amendments of 1983", including raising the age of eligibility for unreduced retirement benefits in two stages to 67 by the year 2027. Workers born in 1938 will be the first group affected by the gradual increase. Benefits would still be available at age 62, but with reduced payments. (There were several other changes made as well. You can find them all at http://www.ssa.gov/history/1983amend.html

Yes, my fellow Americans, there really was a time, when elected officials from both parties, who disagreed on many issues, somehow managed to reach across party lines and come together for the good of the country. I'm old enough to remember when Democratic Senators Robert Kerry of Nebraska and Paul Tsongas of Massachusetts sat at the same table with Republican Senators Warren Rudman of New Hampshire and Allen Simpson of Wyoming and told their fellow members of congress nearly 20 years ago, in one harmonious bi-partisian voice, "America will be in deep trouble in the not too distant future, if we don't get our fiscal house in order."

Tsongas and Rudman founded the Concord Coalition in 1993 along with other prominent Democrats and Republicans. The group's mission statement is to educate "the public about the causes and consequences of federal budget deficits, the long-term challenges facing America's unsustainable entitlement programs, and how to Build a sound foundation for economic growth".

To get a truly responsible and bi-partisan view of the serious economic trouble our country is in go to www.concordcoalition.org.

Simpson was appointed in 2010 to co-chair President Barack Obama's fiscal commission with co-chair Democrat Erskine Bowles
Posted 9/29/10 by:
Bob O'Toole, MSW, LICSW

President
Informed Eldercare Decisions, Inc.
450 Washington Street-Suite 108
Dedham, MA 02026
www.elderlifeplanning.com

Millions of Americans Are Caregivers of Aging Parents-Fewer than 10% Can Afford The Cost

2010-09-28T11:37:00.002-04:00

For the past few years, with more than 200 posts, this blog has cited the growing urgency of the need for eldercare services, the uninsured costs of care and the growing shortage of paid caregivers

The older population--persons 65 years or older--numbered 39.6 million in 2009 (the latest year for which data is available). They represented 12.9% of the U.S. population, about one in every eight Americans. By 2030, there will be about 72.1 million older persons, more than twice their number in 2000. People 65+ represented 12.4% of the population in the year 2000 but are expected to grow to be 19% of the population by 2030.U.S. Administration on Aging www.aoa.gov

Here is a brief summary of some of the data cited in this blog with the sources that data comes from:
78% of adults living in the community and in need of long-term care depend on family and friends as their only source of help. Thompson, L. Long-term care: support for family caregivers. 2004

20 hours per week is the average number of hours family caregivers spend caring for their loved ones while 13% of family caregivers are providing 40 hours of care a week or more. Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 20091.4 million children ages 8 to 18 provide care for an adult relative; 72% are caring for a parent or grandparent; and 64% live in the same household as their care recipient.
National Alliance for Caregiving and the United Hospital Fund, Young Caregivers in the U.S., 2005.
Family caregivers are the foundation of long-term care nationwide exceeding Medicaid long-term care spending in all states.
Evercare Survey of the Economic Downturn and Its Impact on Family Caregiving;
National Alliance for Caregiving and Evercare. March 2009
51% of care recipients live in their own home, 29% live with their family caregiver, and 4% live in nursing homes and assisted living. Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009

36% of family caregivers care for a parent and 7 out of 10 caregivers are caring for loved ones over 50 years old. Caregiving in the United States;
National Alliance for Caregiving in collaboration with AARP. November 2009
What is the uninsured cost to care for a frail elder?

"... in 2005 the median annual rate for a private nursing home room was $60,225, compared with the 2010 median annual rate of $75,190. In many parts of the country, especially on the east and west coasts, daily nursing home rates are now above $300 a day.

This increaserepresents a 4.5 percent compound annual growth rate over that period.
The national hourly private pay median rate charged for a home health aide was $17.50 in 2005, the 2010 hourly rate has crept up to $19.

Home care rates have remainedflat in part because of increased competition. If a person needs only 6 hours per day of care to stay at home the annual cost is about $41,000. A person needing round the clock care at home due to the limitations caused by Alzheimer's disease, Parkinson's disease and stroke. will neeed $166,000 to pay for that care in 2010. More than the cost of a nursing home

A 1 bedroom unit in an assisted living facility ranges from $45,000 to $65,000
Source: 2010 Cost of Care: Long Term Care Survey - Genworth Financial
www.genworth.com/.../long_term_care/long_term_care/cost_of_care.html - CachedNow comes the latest data from the U.S. Census Bureau-released yesterday(Sept 27, 2010)
That tells us that only a tiny minority of frail elders and family caregivers can afford to pay for these costs.
WASHINGTON, Sept 27, 2010 – The income gap between the richest and poorest Americans grew last year to its widest amount on record.

The top-earning 20 percent of Americans — those making more than $100,000 each year — received 49.4 percent of all income generated in the U.S., That ratio of 14.5-to-1 is nearly nearly double the ratio of rich to poor-7.69- in 1968.

The U.S. has the greatest disparity among Western industrialized nations.
At the top, the wealthiest 5 percent of Americans, who earn more than $180,000, added slightly to their annual incomes last year, census data show. Families at the $50,000 median level slipped lower.
Source: Census finds record gap between rich and poor– September 28, 2010
http://www.census.gov

In other words, By 2030, there will be about 72.1 million older persons, but less than 7 million of them will be able to pay for home or facility care if they should need it.

Bob O'Toole, MSW, LICSW
President
Informed Eldercare Decisions, Inc.
450 Washington Street-Suite 108
Dedham, MA 02026
781-461-9637 OR Toll free 1-800-375-0595
http://www.elderlifeplanning.com/

Family Caregivers Save NY State Medicaid program more than $12 billion

2010-09-27T15:58:00.001-04:00

The Rochester, NY based Newspaper the Democrat and Chronicle is running an in depth series that will be of interest to anyone involved with the challenging role of caring for an aging family member who is no longer independent.
"Growing older on your own terms can be a challenge. Here are some issues we face as we seek to maintain our independence or that of our loved ones."

"At any point in the year in New York state, 3.1 million family members, friends or neighbors are caring for a loved one. If they had to hire someone to do what they're doing, it would cost $25 billion. By providing care they save the state's

"Medicaid program more than $12 billion, according to the New York state Office for the Aging.
More than 80 percent of long-term care is provided by informal caregivers who spend financial,
physical and emotional capital. The contributions and costs of that care are drawing attention from government, community groups and others who potentially could ease the burden."
"The commitment of the informal caregivers no longer can be taken for granted," said Lynn Varricchio, senior health planner with the Finger Lakes Health Systems Agency and staff member to the agency's Sage Commission. The commission recently released its first-year report, 2020 Vision for Aging Services, that listed objectives and recommendations for improving care to seniors. "We have to support it not just with nice words but in substantive ways."

"The state Office for the Aging last year released three reports on caregiving that identified overall issues and made recommendations for support; profiled for the first time caregivers and receivers and the economic impact of caregiving; and reviewed availability of services around the state. The results are expected to guide government and communities as they develop and extend the reach of programs. Much of the care is directed toward seniors, but other adults and even children are recipients."

"Dr. Brian Heppard, vice president of medical services of Jewish Senior Life, said that the community ultimately supports people receiving care when it bolsters the people providing it."
"They are able to sustain that effort of being a caregiver for much longer. If they can continue to be a caregiver, their loved one can stay at home that much longer.

Dr. Thomas Caprio, director of the University of Rochester Geriatric Assessment Clinic, said that caregivers can feel consumed by their role. If they were to take time for themselves and something were to happen, they may think they failed.

"The stress is a constant demand on their time, worry about their loved one and a sense of guilt."

"Studies have shown suppressed immune function among caregivers and that one-third to more than one-half have symptoms of depression, whether or not they have been diagnosed, Caprio said."
"Other caregivers are facing economic stress. Studies have shown that caregivers spend about $5,500 per year on the person they are tending to. In New York, 57 percent of caregivers are between the ages of 40 and 64, meaning they are likely to be balancing responsibilities at home with their job. "
"According to the 2006 MetLife Caregiving Cost Study, at least 60 percent of employed caregivers reported making some adjustments at work because of their responsibility. Nine percent left the workplace and 10 percent reduced their hours. For those still on the job, the loss to the nation's employers runs into the billions of dollars."
"This is just a brief excerpt of an extensive and informative article. Go to the web site of the Rochester Democrat and Chronicle to read the full article and the rest of this six part series
http://www.democratandchronicle.com/article/20100927/NEWS01/9270301/1002/NEWS

Sunday: Home health aides
Today: Informal caregiving
Tuesday: Aging in place
Wednesday: Naturally occurring retirement communities
Thursday: A new model of home
Friday: Planning for your future

To get more information on low cost family caregiver support programs for employers, banks, labor unions and faith based organizations click on the following link: http://www.elderlifeplanning.com

Eldercare Facility to Pay $50 Million Settlement for Failing to Provide Adequate Staffing at Assisted-living Facilities.

2010-09-14T14:48:00.000-04:00

By PAUL ELIAS - Associated press Writer A California nursing home company has agreed to pay $50 million to settle a lawsuit that resulted in a $677 million jury award in favor of thousands of current and former patients.

Orange County-based Skilled Healthcare Group Inc. announced the settlement late Tuesday. The money will go to the roughly 32,000 patients covered by the class action lawsuit. It will also cover attorneys' fees.

The $677 million awarded by a Humboldt County Superior Court jury in July is believed to be the largest jury verdict in the country this year.
During Cindy Cool's almost daily visits to the nursing home, she would routinely find her Alzheimer's-suffering father wearing urine-soaked clothes.

The Blue Lake resident said it would take upwards of 20 minutes for the apparently short-handed staff of Eureka Healthcare and Rehabilitation to respond and help Cool clean her father. Other patients fared worse, she said.

"A lot of times I walked out of there crying because of the things I saw," Cool said in an interview.

Nursing home operator Skilled Healthcare, which owns two homes in the central San Joaquin Valley, has been ordered to pay more than $671 million for failing to provide adequate staffing at its assisted-living facilities.

A Humboldt County jury returned the verdict Tuesday in the class-action lawsuit against the Foothill Ranch-based company, more than seven months after the civil trial began.

The lawsuit alleges that the company violated a California statute that mandates 3.2 nursing hours per patient per day.

Orange County-based Skilled Healthcare Group Inc. announced the settlement late Tuesday. The money will go to the roughly 32,000 patients covered by the class-action lawsuit. It will also cover attorneys' fees.

The jury determined that Skilled Healthcare illegally skimped on state-mandated staffing levels at its 22 nursing homes in California. State law requires that nursing homes maintain 3.2 hours of nursing care per patient per day.

Critics of the nursing home business such as Pat McGinnis, executive director and founder of the California Advocates for Nursing Home Reform, say staffing shortages are a problem throughout the industry.

For the full article go to : http://www.fresnobee.com/2010/09/08/2070685/nursing-home-co-settles-677m-lawsuit.html#ixzz0zVsMERjc

AFL-CIO Says Former Senator Simpson "Rants Against Seniors" Again.

2010-09-03T13:12:00.000-04:00

Mike Hall, writing in the "AFL-CIO NOW" blog (blog.aflcio.org) last week, was highly critical of Former Wyoming Senator Alan Simpson. Simpson, a Republican, is the Co-chairman of the Bi-Partisan Federal Budget Deficit Commission appointed by President Obama.

Hall says that Senator Simpson,"sent a nasty e-mail" to Ashley Carson, executive director of the Older Women’s League (OWL), berating her for an an article she wrote for the Huffington Post in which she takes him to task for distorting the opposition to the Social Security cuts. Raising the retirement age is one such potential cut, one that Simpson supports.

Hall states that Simpson attacked Carson in his e-mail saying “people like you babble into the vapors…and all the rest of that crap.” Simpson says that Social Security is “like a milk cow with 310 million tits” and signs off by telling Carson, “Call when you get honest work.”

When he was in the Senate, Simpson was considered a "moderate Republican" when that party still had a few moderates. He often worked closely with such prominent Democrats as Paul Tsongas of Massachussets and Robert Kerry of Nebraska to raise awareness of the dangers of the growing national debt. Since leaving the Senate, Simpson has taught periodically at his alma mater, the University of Wyoming, as well as the John F. Kennedy School of Government at Harvard University.

"The acerbic rant is one of Simpson’s favorite weapons to turn on anyone who disagrees with him" Hall says. "Previously, Simpson called seniors “greedy geezers;” described lower-income Americans as “lesser people in society;” and complained that he is frustrated hearing from retirees who “live in gated communities and drive their Lexus to the Perkins restaurant to get the AARP discount.”

In a joint letter to President Obama, Alliance for Retired Americans President Barbara Easterling and Executive Director Edward F. Coyle urged the president to demand Simpson’s resignation. They wrote that his remarks are "conduct unbecoming a person named to co-chair a presidential panel. Moreover, it is the latest in a series of derisive and inappropriate comments Mr. Simpson has made about our nation’s seniors and the Social Security benefits they have earned and rely upon to make ends meet."

I urge you to read Hall's full blog post at blog.aflcio.org as well as the more than 25 responses, most agreeing with Hall. Do you think Simpson raises some legitimate points about the need to contol entitlements for older Americans? Do you think that President Obama should remove him from the Federal Budget Deficit Commission?

5 Ways to Cut Elder-Care Costs

2010-08-10T11:58:00.000-04:00

SmartMoney.com published these tips on their web site about a year ago. They are worth revisiting as state and federal budget crises force steep cutbacks in publicly funded services to elders.

FYI: Smartmoney.com has consistently published some excellent articles related to the costs of eldercare and I highly recommend that you visit and bookmark their website.

On average, Family and informal caregivers who take care of an elderly friend or relative spend $5,500 a year just on the day-to-day expenses like food and doctor visits, according to a 2007 study by the National Alliance for Caregiving .... The average annual cost of a semi-private room in a nursing home is $69,715, while the average cost of an assisted living facility is $36,372 a year, according to a 2008 MetLife survey.

Don't expect much help from the government. Medicare will only cover the total cost of staying in a skilled nursing facility for up to 20 days and won't cover the cost of an assisted-living facility or home care at all, says Mary Winners, owner of About Senior Solutions, a referral service and advocacy organization in Monrovia, Calif.
In fact, without long-term-care insurance, which typically covers the cost of nursing homes, assisted-living facilities and in-house care, the last years of a senior’s life can be financially devastating for everyone involved.

To help you better manage the costs of caring for an elderly loved one, follow these tips.
Negotiate

It never hurts to ask. Try negotiating on price with a facility, especially if they aren’t filled to capacity. “
Offer to share a room

Some assisted-living facilities set aside a certain number of shared rooms for lower-income seniors who can’t afford the full fee, says Schempp.
Winners, the owner of About Senior Solutions, says she knows of some facilities that may charge as low as $1,300 to $1,700 (per person) for a shared room, when a private-room rate would be $2,500 to $3,500

Hire a geriatric-care manager

A geriatric-care manager can do everything from assessing your parent's long-term care needs and finding them a place to live to helping you navigate the oh-so-complicated health-care system. Not only that, but they can save you plenty of time and money -- making their fees, which range from $80 to $200 an hour, a lot more palatable.
Say you live far away from your aging mother and she needs regular assistance. A manager may be better able to find a high-quality assisted-living facility near her home that's subsidized by the community. “A care manager knows what’s out there” and can negotiate on your behalf, says Maryann Higgins, owner of Connections Inc., a geriatric-care management service in Sarasota County, Fla.

They can also serve as a much-needed mediator when family members are in conflict over an elderly relative's care. That alone, can save you plenty of time -- and headaches, says Donna Wagner, director of the gerontology program at Towson University.
Search the National Association of Professional Geriatric Care Managers' site to find a manager in your area.
http://www.caremanager.org
Adult day care
If you work during the day and your parent can't be left home alone, enrolling them in an adult day care is a more affordable option than private, in-home care. Fees for adult day services vary, but the national average rate is $64 a day, compared with an hourly rate of $20 (or $160 for an eight-hour day) for home health aides...

Contact your state’s department of aging to get recommended adult day care centers, or search the National Adult Day Services Association for centers by state here.

Hire a part-time caretaker

For seniors who don't require close or full-time supervision, hiring someone to regularly check in and spend time with your elderly parent may be all you need. It could be a neighbor or someone from the local church. Or, if your mom or dad lives near a university, hire a student.

Check with your local university, or faith-based organization (like Catholic Charities or Jewish Family Service), which have volunteers and planned activities for seniors.

Another option: Offer to pay a friend or neighbor to check on your parent.

Read more: 5 Ways to Cut Elder-Care Costs - Personal Finance - Retirement - SmartMoney.com http://www.smartmoney.com/personal-finance/retirement/5-ways-to-cut-elder-care-costs/#ixzz0wDE6OiUw

Elder Caregiving Places a Brutal Toll on Spousal Caregivers

2010-08-08T17:51:00.000-04:00

In an article published in the Contra Costa County Times (SF CA area), Linda Fodrini -Johnson, who is currently serving as President of the National Association of Professional Geriatric Care Managers, discusses the effects on the "healthy" spouse who is the primary caregiver for their now disabled partner.

"For a sick or disabled relative exacts a brutal toll -- physical, emotional, financial -- on any involved family member. But for spousal caregivers, the challenges and traumas are even greater, says Linda Fodrini-Johnson, executive director of Eldercare Services in Walnut Creek. "

"It's the long goodbye. You're slowly losing the person you've become accustomed to sharing your life with," she says. "And now that person can no longer give you what you want or need. You have more loss. Your heart is more broken."

"She points out that spousal caregivers typically take on greater burdens than they can reasonably handle and wait longer to ask for outside help, because they feel like it would "betray the relationship."

"And too often they pay a high price in terms of their own health. Studies have shown that spousal caregivers are prone to loneliness, depression and insomnia. And the American Medical Association reports that elderly caregiving spouses have a 63 percent higher chance of dying than people the same age who aren't caring for spouses."

"It isn't all that uncommon," says Fodrini-Johnson, "for the caregiver to precede his or her spouse to the grave."

"Complicating matters is the fact that spousal caregivers find themselves presiding over the gradual disintegration of the most vital relationship of their lives. They dearly miss the healthy, vibrant version of their mate. And because of the constant demands on their time, they lose many of the things that were part of the relationship: dinners with friends and family, holiday events, vacations, birthday parties, graduations, the birth of a grandchild."

For the complete article from the Contra Costa Times follow this link:
http://www.mercurynews.com/family-relationships/ci_15686085

Fast-growing Sector of Senior Housing is Coming Under Increased Scrutiny in Washington.

2010-07-29T11:21:00.000-04:00

Fast-growing Sector of Senior Housing is Coming Under Increased Scrutiny in Washington.

On Wednesday, July 21 a Senate committee was scheduled to hold a hearing to discuss mounting concerns about continuing-care retirement communities, according to the Wall Street journal. Also known as or CCRCs, these luxury housing complexes often charge large upfront fees, of $250,000 or more, plus monthly maintenance fees in exchange for the promise of lifetime care. The Journal also reports that the Government Accountability Office releases a report urging state regulators of the CCRCs to be vigilant in their oversight of the communities.

The Journal's Anton Troinanovski reports that "During the real-estate boom, the communities attracted thousands of residents as well as investors seeking to capitalize on the wave of Baby Boomer retirees. Many CCRCs were built by for-profit development companies, and some investors flocked to the high-yield municipal bonds often used to finance the communities. But demand for CCRC units dropped during the recession as fewer seniors were able to afford the steep entrance fees. ...That threw some highly leveraged communities into financial distress, leading some consumer advocates and politicians to question whether seniors living in CCRCs are sufficiently protected."
"The report names unexpected increases in monthly fees and the loss of the refundable entrance fee as potential risks to seniors who live in a community that is struggling financially. The GAO found that regulations vary from state to state, in particular regarding assessing the long-term viability of CCRCs. Twelve states don't have CCRC-specific regulations at all, according to a recent study cited in the report. "

http://online.wsj.com/article/NA_WSJ_PUB:SB10001424052748704723604575379422092146814.html

Some Eldercare Agencies Not Paying Wages Owed to Workers

2010-07-27T13:36:00.000-04:00

Kevin Cobb , Sr. VP for Client Services at Focus1 HR Group in Austin, Texas
http://www.focus1hr.com/ has posted an informative information piece at the social media site LinkedIn about an issue that needs to be closely monitored as labor shortages grow in the eldercare industry.
http://www.linkedin.com/pub/kevin-cobb/0/b24/8b1

Kevin was commenting on recent legal proceedings against a Massachusetts based Home Care provider that has been arraigned for failing to pay over $470,000 in wages to nearly 100 employees.

The Massachusetts Attorney General alleges that Ms. Porter and her company failed to properly pay their employees all of the money they were owed for the hours that they worked.

In March 2009, the Attorney General’s Fair Labor Division cited Porter and her company for over $21,000 in restitution and fines after investigators found that Excel Home Care violated the Massachusetts wage and hour laws by failing to pay many employees for hours worked in 2008.

In his comments, labor specialist Cobb states that situations like this are not uncommon and is often a misunderstanding of how to properly classify an employee rather than a blatant attempt to cheat an employee.

"Many industries (including home health) utilize contract employees. However, your interpretation of who may be a contract employee (and the employee’s interpretation as well) may differ from the IRS and the state unemployment commissions interpretation. Even if both you and the employee agree in writing that they are a contractor (and not subject to various FLSA regulations & taxes), the IRS may decide otherwise. This leaves you open for back wages for hours worked, back overtime, back taxes (including the employees portion of FICA), back unemployment taxes, and penalties."

"Many companies stick a “salaried” label on an employee and think that covers everything." says Cobb

"...in the home health field, there are companies that pay only when the nurse/provider is at a patient’s home, but not for travel in-between. There are instances where that is acceptable, but typically not if they are hourly/salary non-exempt. There are ways to reduce the impact of travel time, but it cannot be ignored. "

CBS Moneywatch: The Importance of Long-term Care Insurance

2010-07-25T17:03:00.001-04:00

JULY 23, 2010
CBS Money Watch has an article on Complicated financial decisions when planning for old age.
Columnist Charlie Farell says that long-term care insurance is one of the least understood types of insurance in the market. "It’s unfortunate" Farrell says, "because many people will probably need it."

LTC insurance pays for the cost of long term care, which generally includes nursing home care and home care. LTC expenses are in general not covered by Medicare, and thus many retirees will need some coverage for these potential costs.
"If you haven’t checked yet, nursing home care, or comparable home health care, can easily cost $80,000 a year (or $160,000 if both you and your spouse need it). So this is a big financial risk that many people can’t afford to self insure."

"This is also an area where you should consider getting help from a qualified and trusted insurance agent. If the agent is good, he or she can help you sort through the various types of plans and features."
LTC policies come in all different shapes and sizes, and you’ll need to make decisions about how long a benefit period you want (such as three year or maybe even lifetime payments), how much of a waiting period you can handle and how much of a daily benefit you need, just to name a few."

"LTC insurance is complicated, and additional bells and whistles customized to your needs, along with the guidance of a good insurance agent, is probably a good idea."

For the full article follow this link to CBS Money Watch: http://moneywatch.bnet.com/retirement-planning/blog/retirement-roadmap/when-to-pay-more-for-financial-bells-and-whistles/3287/

Virginia Launching Portable Housing for Aging Relatives .

2010-07-18T18:14:00.000-04:00

As Reported in The Washington Post By Fredrick Kunkle
SALEM, VA. The Rev. Kenneth Dupin, who leads a small Methodist church here, has a vision: As America grows older, its aging adults could avoid a jarring move to the nursing home by living in small, specially equipped, temporary shelters close to relatives.

So he invented the MEDcottage, a portable high-tech dwelling that could be trucked to a family's back yard and used to shelter a loved one in need of special care.

Skeptics, however, have a different name for Dupin's product: the granny pod.

Protective of zoning laws, some local officials warn that Dupin's dwellings -- which have been authorized by Virginia's state government -- will spring up in subdivisions all over the state, creating not-in-my-back-yard tensions with neighbors and perhaps being misused....Such temporary shelters might work in rural and sparsely developed parts of the state, McKay said, but the impact could be enormous in crowded urban and suburban areas.

"This basically sets up an opportunity to do something legally which, prior to this, had been illegal -- which is to set up a second residence on a single-family property. It turns our zoning ordinance upside down," McKay said.

The MEDcottage would be equipped with the latest technology to monitor vital signs, filter the air for contaminants and communicate with the outside world via high-tech video. Sensors could alert caregivers to an occupant's fall, and a computer could remind the occupant to take medications. Technology could also provide entertainment, offering a selection of music, reading material and movies.
The dwelling would take up about as much room as a large shed and, like an RV, could connect to a single-family house's electrical and water supplies. It could be leased for about $2,000 a month, a cost Dupin hopes will be borne by health insurers.

The law defines the MEDcottages as "temporary family healthcare structures" that can be placed only on the properties of single-family homes and occupied only by a relative who is physically or mentally impaired, as certified by a physician. The structures must be less than 300 square feet and conform to local regulations governing sheds or garages. They must be removed within 30 days after the occupant dies, moves or no longer needs to receive care in the dwelling.

The Most Devoted Family Caretakers are at Risk of Dying First Themselves

2010-06-29T18:29:00.000-04:00

In an earlier post to this blog, we mentioned Gail Sheehy's important new book on caring for elders, the latest in her "Passages" series.

In a current article in Newsweek titled "The Caregiving Boomerang", Sheehy discusses how serious the effects of caregiver stress can be.

"The most devoted family caretakers are at risk of dying first themselves...."

Fifty is the gateway to the most liberating passage in a woman’s life. ...to pursue your passion. Climb mountains. Run rapids. Rediscover romance. You have a whole Second Adulthood ahead of you!

That has been the message of my books since I wrote New Passages 15 years ago. What I didn’t see coming was the Boomerang.

"With parents living routinely into their 90s, a second round of caregiving has become a predictable crisis for women in midlife. Nearly 50 million Americans are taking care of an adult who used to be independent. Yes, men represent about one third of family caregivers, but their participation is often at a distance and administrative. Women do most of the hands-on care. The average family caregiver today is a 48-year-old woman who still has at least one child at home and holds down a paying job."

"When that call came to me, I froze. The shock plunges you into a whirlpool of fear, denial, and feverish act-ion. You search out doctors. They don’t agree on the diagnosis. You scavenge the Internet. The side effects freak you out. You call your brother or sister, hoping for help. Old rivalries flare up. You haunt the corridors of the hospital, always on duty to prevent mistakes."

"It begins to dawn on you that your life is also radically changing. This is a caregiving role that nobody applies for. You don’t expect it. You aren’t trained for it. And, of course, you won’t be paid for it. You probably won’t even identify yourself as a caregiver. So many women tell me, “It’s just what we do.”

"There are many rewards in giving back to a loved one. And the short-term stress of mobilizing against the initial crisis jump-starts the body’s positive responses. But this role is not a sprint. It usually turns into a marathon, averaging almost five years. "

"The hypervigilant caregiver becomes exhausted, but can’t sleep. Chronic stress turns on a steady flow of cortisol. Too much cortisol shuts down the immune-cell response, leaving one less able to ward off infection. Many recent clinical studies show that long-term caregivers are at high risk for sleep deprivation, immune-system deficiency, depression"

To read the full article follow this link.http://www.newsweek.com/2010/06/18/the-caregiving-boomerang.html

Medicaid's Long-Term Care Time Bomb

2010-06-24T17:41:00.000-04:00

Howard Gleckman’s ’ Blog “Caring for our Aging Parents” is a must read. If you are interested in a serious and informative commentary on America’s long-term term care mess I suggest you bookmark the following link: http://abytesgen01.securesites.net/howard_gleckman/2010/06/medicaids-long-term-care-time.html
Yesterday he called attention to a report from Deloitte’s Center for Health Solutions, which confirms several of the postings that have appeared on this blog over the past two years.

I have not yet read the full report but, according to Gleckman it says in part that “Medicaid long-term care is well on its way to destroying state budgets.” “…Medicaid long-term care benefits for both home and nursing facility care will absorb a staggering 18 percent of total state budgets if current trends continue. Overall state Medicaid spending will almost double by 2030 and the total program, including acute care benefits”

Gleckman sees drastic cost cutting coming well before the Deloitte studies estimates are realized. “This outcome is, honestly, impossible. Long before states face these costs, they will slash the program, either by cutting benefits, limiting eligibility, or both. We can already see this happening in the current recession, where state home and community programs are being cut and nursing home payments frozen or trimmed.”

“The Deloitte study”, says Gleckman “is more evidence that, in the long run, we need to get Medicaid out of the long-term care business. And to do that, we need to build on the just-passed CLASS Act and make long-term care an insurance program, not a welfare program. Trying to preserve the broken Medicaid system will only bankrupt states even as it provides families with the wrong care, at the wrong time, and in the wrong place. “

New Study Says Older Workers Retiring Will Create Skills Shortage for U.S. Manufacturers

2010-06-22T17:52:00.000-04:00

MORE HARDSHIP AHEAD FOR US MANUFACTURING

Talent Pressures and the Aging Workforce: Responsive Action Steps for the Manufacturing Sector by Stephen Sweet and Marcie Pitt-Catsouphes et. al.

June 2010--A wave of retirement in the manufacturing sector could plague US companies with skill shortages and high costs of replacing veteran employees.

Overall, manufacturing employers reported their top three concerns were:

•Recruiting competent job applicants (45.1%);

•The low skill levels of new employees (30.3%); and

•Knowledge transfer from experienced to less experienced employees (28.8%).

Top skills reportedly in short supply include:

•Management skills (37.4%);

•Legal skills (33.3%);

•Sales/marketing skills (28.2%)

•Operations skills (24.4%); and

•Technical computer skills (22.1%).

These findings are an especially dire sign for US manufacturing because of significant replacement costs. The median cost of replacing employees in the manufacturing sector is $5,000 per employee, compared to $3,000 per employee in other sectors.

Quick Facts and Figures80% of care for older adults is provided by family members

An estimated 44% of caregiving daughters and 55% of caregiving sons are employed

The emotional and physical strains of caregiving often lead to deterioration of the caregiver's own health and increased time away from work
Nearly 20% of employed caregivers ultimately quit their job

Elder Life Planning for Organizations helps business owners, employees, participating organizations, and families solve caregiving problems.

ELPO is a nationwide program that helps any caregiver with the issues inherent in eldercare, whether the elder lives in a nursing home, at the employee's home, or in another state.

To find out how your company, bank, or other organization can offer this low-cost, high-value benefit, contact Bob O’Toole at 1-800-375-0595.

New Series of Recommended Resources for Caregivers

2010-06-22T17:30:00.000-04:00

Gail Sheehy: "Passages in Caregiving" More than 50 million Americans are caring for a spouse, parent or relative who has a serious illness. Author and journalist Gail Sheehy identifies eight crucial stages of caregiving, drawing on her experience caring for her husband...

http://thedianerehmshow.org/audio-player?nid=12462

"I had no idea, then, just five years ago, that there was such a thing as a professional geriatric care manager. Or a person like Linda Fodrini-Johnson at the other end of a telephone line.
Linda is the president of the National Association of Professional Geriatric Care Managers. There is a Linda in every zip code. Breathe out and let the panic abate. This is an organization of objective–– caring, of course; compassionate, absolutely certified professionals in the fields of nursing, and gerontology and all the things a Designated Daughter doesn’t know.

http://dailywd.womansday.com/blog/2010/06/designated-daughter-panic-go-round.html

Talk to relatives about caregiving before they need it; resources that can help

Ask about insurance policies including long-term care, disability and life.

Discuss all the possible living options should that need arise. The options may include home modifications (to yours or theirs), home care, assisted living, senior day-care centers and nursing homes.

Share information you've gotten from your local office of aging. You can find the contact information by going to http://www.eldercare.gov.

For added support, consider hiring a geriatric care manager, a professional who specializes in helping families who are caring for older relatives. "When siblings are spread across the country, this person can help you come up with a game plan before something happens," says Kaaren Boothroyd, executive director of the National Association of Professional Geriatric Care Managers. The cost can range from $80 to $200 per hour. But the fee could be more or less depending on where you live. You can find more information on this topic at http://www.caremanager.org/.

http://www.washingtonpost.com/wp-dyn/content/article/2010/06/02/AR2010060204497_2.html

Congress Misses Medicare Payment Cut Deadline

2010-06-12T16:56:00.000-04:00

Doctors May Soon Be Forced to Accept Lower Reimbursements for Treating Medicare Patients

A missed deadline by Congress may mean many of the country's 44 million Medicare patients will have a harder time finding a doctor -- piquing the frustration of many physicians who already care for these patients.

On Friday, the Senate adjourned for its traditional Memorial Day break without eliminating a physician payment cut for treatments to Medicare patients that took effect today, which means that the country's doctors may soon be paid 21.3 percent less to treat Medicare patients.

In a statement issued Friday, Dr. James Rohack, president of the American Medical Association, expressed outrage.

"The Senate has turned its back on seniors," Rohack said in the statement. "Senators are more interested in heading home for the holiday than in preventing a Medicare meltdown for seniors... Already, about one in four Medicare patients looking for a new primary care physician have trouble finding one, and Congressional inaction will make it much worse."

Feds May Force States to Make Further Eldercare Service Cuts

2010-06-07T16:40:00.001-04:00

States Face Budget Scramble As Chances For Federal Medicaid Assistance Extension Get Slim

Kaiser Health News reports that a decision by House Democratic leaders to advance a bill that did not contain enhanced Medicaid funds for states has triggered a wave of state-level reaction. The Kaiser Health News is published by the Kaiser Foundation, a nonprofit news organization committed to in-depth coverage of health care policy and politics.
"... National Association of State Budget Officers said states are "in fiscal peril" and that "governors face a 'cliff' when the extra $87 billion provided for Medicaid in the 2009 stimulus package runs out Dec. 31."

Congress initially provided these stimulus funds to help states make health care accessible to the millions of low-income people impacted by the recession. Now ... the National Governors' Association is pressing lawmakers to provide the additional amounts — at a cost of $23 billion — through next June.

One of the reasons this issue is causing such concern: "Under the health care overhaul law, states can no longer increase premiums or otherwise change eligibility criteria for Medicaid. That means their options for cutting costs are limited to things like reducing provider reimbursements, increasing co-payments or dropping coverage for optical and dental services"

"States are bracing for the budgetary hit they will face if Congress does not provide these funds. The Los Angeles Times estimated the amount for California could tally as much as $2 billion..." "The Washington Post reported that "Virginia, like 20-plus other states, included some drastic cuts to health and human resources," and, for Nevada, the cost of stripping the Medicaid funding provision from the jobs bill could cost the state as much as $88 million, according to The Associated Press/Las Vegas Sun.

For more details on this financial impact of publicly funded eldercare services visit the Kaiser Health News web site at: http://www.kaiserhealthnews.org/Stories/2010/June/04/health-policy-week-in-review.aspx?utm_source=feedburner&utm_medium=feed&utm_campaign=Feed%3A+NewFromKaiserHealthNews+%28New+From+Kaiser+Health+News%29

Keeping Track of Dedham MA Seniors with Alzheimer's

2010-06-04T11:35:00.000-04:00

Keeping track of seniors with Alzheimer's

The e-mail alert shouted its message: "Missing Person with Alzheimer's. PLEASE HELP." It was sent to Alzheimer's Assn. chapters and to law enforcement officials within hours after an Orange County woman disappeared while on a short trip to visit a friend…

That story has a happy ending, but many confused seniors who become lost are never found again. The Alzheimer's Assn. estimates that 60% of individuals with Alzheimer's will wander at least once during the progression of the disease. Up to 70% of these individuals wander more than once, and up to several times. One study reported that nearly half of those not found within 24 hours die — usually from dehydration, exposure or injury.

Finding Affordable Long-Term Care

2010-05-28T16:27:00.001-04:00

How to Find Affordable Long-Term Care

A prolonged illness or chronic condition could end up being one of your biggest retirement expenses. Medicare pays for a maximum of 100 days of nursing home care before retirees must absorb the remaining cost themselves. However, depending on the level of assistance that you need, there are some inexpensive care options and ways to protect yourself from excessive long-term care costs. Here are a few ways to find affordable long-term care:

Eldercare Workforce Alliance Formed to Address Nation's Worsening Eldercare Crisis

2010-05-27T12:10:00.002-04:00

The Eldercare Workforce Alliance is a group of 28 national organizations, joined together to address the immediate and future workforce crisis in caring for an aging America.

"...the Alliance will build a caring and competent eldercare workforce, joining in partnership with older adults, their families and other unpaid caregivers-to provide high-quality, culturally-sensitive, person-directed, family-focused care, and improve the quality of life for older adults and their families.

We believe that: An essential step in addressing our fragmented health and long-term care system is to adopt care models that provide well-coordinated, person-directed and family-focused services across settings. All unpaid caregivers - including family, friends and other caregivers-should be supported and have opportunities to acquire the needed skills, knowledge, and information to care appropriately for older adults."

"Resolving the workforce crisis requires addressing recruitment, retention, training and compensation issues across the direct-care and professional health care workforce-which is essential to improve the quality of care and quality of life for older adults."

To learn more about the Eldercare Workforce Alliance visit their web site at http://www.eldercareworkforce.org/

Recognizing and Preventing Financial Abuse of Elders

2010-05-26T13:28:00.005-04:00

Here are some good suggestions from Forbes Magazine that every adult child of a frail older parent should consider
http://www.forbes.com/2010/05/18/elder-care-retirement-personal-finance-aging-parents.html

"...My friend talked to his mother at length about her sweepstakes obsession and finally confiscated her checkbook, took over her bank accounts and had her mail diverted to his own home. With no sweepstakes offers arriving at his mom's house, she slowly returned to her community activities. For my friend, who'd ignored signs along the way and let the situation reach the breaking point before intervening, the solution required months of effort."

"At least he'd had the power of attorney that enabled him to act and had his mother in a good assisted living facility. Imagine the difficulties when none of this is in place. Being proactive early on, rather than reactive after problems arrive, provides adult children with the tools to intervene effectively. Here are some important proactive steps to make sure you and your family are prepared:

--Establish a financial power of attorney. If your parent has concerns about losing control, consider a "springing" power that goes into effect only after the parent is unwilling, or unable, to make financial decisions alone.

Add a durable power of attorney for health care to the estate plan. Be sure to discuss with your parent and family what medical treatment is, and is not, desired.

Consider working with a financial advisor who specializes in multigenerational planning. This can help you balance the needs of parents for elder care, your own children for college and you for retirement. Aging parents may also be more apt to cooperate after receiving advice from an outside expert.

Add a family member to your parents' safe deposit box and keep track of the key.

Legal Issues Faced by Caregivers in Massachusetts and Other States

2010-05-23T12:57:00.002-04:00

7 Legal Issues That Caregivers Face

As people reach old age, they become more vulnerable. Too often, they are taken advantage of. It's not only strangers, but also family members who exploit an elderly person's defenselessness. In addition, the caregivers who are trying to take care of their elderly parents often find themselves in sticky legal situations.

Here are some horror stories from the AgingCare.com message boards about the legal trouble that elderly people and their family caregivers have had:

Prepare for Long-Term Care Costs Before You're Hit with Sticker Shock

2010-05-13T16:37:00.002-04:00

Prepare for the Rising Cost of Long-Term Care

The price tag of a nursing-home room will continue to grow at a fast pace, but there are ways to offset the cost.

How much is long-term care expected to cost in 20 to 30 years? I’m in my fifties now and am wondering what the price might be to receive care in a nursing home or my home in the future.

The cost of long-term care is already high and is expected to grow at a brisk pace for the next 20 to 30 years. The median cost of a private room in a nursing home now is $206 per day across the country, which adds up to more than $75,000 per year, according to Genworth Financial’s recent Cost of Care study. And the median cost of care from a licensed home health aide is $19 per hour, which equals $152 per day for eight hours of care -- or more than $55,000 a year.