The Financial Toll of Elder Care in America

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To age well and securely in America is expensive on every level. The financial toll for millions of the elderly and those families who do their best to care for and support them. Long-term care facilities and retirement communities cost staggering amounts of money, as do the high costs of premiums to maintain a long-term care insurance policy. The truth is the US long-term care system is both underfunded and not well matched to the expectations of the older adults trying to thrive within it. There exists a crisis in care and a crisis in conscience within this country’s social safety net.

What is the Causes of the High-Cost of Elder Care?

The reasons are many and create a confluence that spells financial disaster for many in America.

  • The aging baby boomers who increasingly require more care
  • Workforce shortages or limitations (COVID-19) in healthcare or Long Term Services and Supports (LTSS) systems
  • Federal and state efforts to segue responsibilities to home and community-based services and family rather than improving social safety net policies
  • Increasing numbers of Americans identifying themselves as caregivers
  • The insurance projections that underfunded the costs of long-term care decades ago
  • Fewer workers paying into the system

More than three in four people, or seventy-seven percent, according to the American Association of Retired Persons (AARP), agree with the following statement “I’d really like to remain in my community for as long as possible.” Indeed, the majority of aging Americans want to do so in their own homes.

Studies show much of the caregiving provided is family-driven. Like paid caregivers, their work is often unnoticed, under-discussed, and unappreciated. It can have devastating consequences on their retirement planning, affecting the next generations of their family and perpetuate this problem cycle. Vox reports the most recent data from AARP, which constitutes 41.8 million people or 16.8 percent of the US population, are currently caregiving for an adult of 50 years or more. A full 28 percent of these care providers have stopped saving money, 23 percent are accumulating more debt, 22 percent have depleted their short-term savings, and 11 percent report being unable to fund basic needs, including food.

The Dilemmas of the Caregiver System in America

The more significant belief that caregiving is a “family responsibility” permeates the US consciousness. And politicians and policymakers who promote this mindset remain unable to redress the shocking costs of eldercare, thus imposing the caregiver reality upon family systems. By extension, many family caregivers’ labor is characterized as something done out of instinct or love, devaluing the complex, primarily unpaid work.

This devaluation of caregiver labor exists for paid caregivers in institutional settings, leading to paychecks that do not constitute a living wage and shortages of caregivers, often women, particularly women of color. Low and stagnant wages continue even as demand skyrockets because many home health workers were not designated as “essential” during the pandemic. Also, the moment a more lucrative opportunity presents itself, and the worker is gone. With new COVID-19 variants on the horizon, the need for caregivers will remain high while their valuation remains low.

Outside of those people providing this elder care, the difficulties remain largely invisible. There are fewer resources than ever chasing the needs of millions. Impoverished Americans with less than 2,000 dollars qualifying them for Medicaid find that with 80 million documented low-income Americans, waiting lists for home care assistance has an average wait time of more than three years. What happens if they have no family to rely on during this waiting period?

As demand for care continues to rise for the increasingly older and infirmed population, the supply of private institutional care is prohibitively expensive, and care within families is substantially contracting with smaller and more widespread family systems overall. Existing social policies are not meeting the needs. Aging in the American landscape needs political reimagining to protect families and stop subverting grievances and social responsibilities to those caregiving workers (paid and unpaid) least likely to thrive providing this care. It is essential to preserve the dignity and care of our older generations and those providing this care. It is incumbent upon the US government to identify the ways to do so affordably.

Please call our Ruston office at 318-255-1760 if you need assistance in planning for yourself or a loved one.

Living Alone in Your 50’s and 60’s Means a Greater Risk of Dementia

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Living situations for aging Americans are decidedly leaning towards aging in place. Nearly all older adults prefer to age in the comfort of their long time homes and familiar community surroundings. Aging in place often means living alone. Pew Research findings show that older people are more likely to live alone in the United States than in any other country worldwide. This preference of living solo, however, comes with hidden danger. Research from Science Times reports that living alone in your fifties and sixties increases the likelihood of dementia by thirty percent.

The conclusion drawn is based on a report from sciencedirect.com, a website replete with large databases of scientific, academic, and medical research. Findings indicate that social isolation is a more important risk factor for dementia than previously identified. In this age of gray divorce (also grey divorce) and social distancing due to the coronavirus pandemic, adults living alone in their fifties, sixties and beyond, are at greater risk than ever for cognitive decline, leading to dementia.

Understanding the Causes of Dementia Cases

The lead author of the study, Dr. Roopal Desai, says that overall increases in dementia cases worldwide can be due to loneliness, stress, and the lack of cognitive stimulation that living alone brings. Biologically, cognitive stimulation is necessary to maintain neural connections, which in turn healthily keep a brain functioning. Staying socially interactive is as important to cognitive health as staying physically and mentally active.

Strategies for Seniors Living Alone

Health care professionals in the U.S. are implementing a “social prescribing” strategy to improve the connection of a patient who lives alone to a prescribed range of services like community groups, personal training, art classes, counseling, and more. Unfortunately, in the days of COVID-19 social prescribing is limited to virtual connections between people. However, virtual social engagement is better than no social engagement at all.

Why can’t an adult, choosing to age alone, maintain their health with physical exercise, crossword puzzles, and other activities that stimulate their brains without the input of human socialization? It turns out that social isolation presents a greater risk for dementia than physical inactivity, diabetes, hypertension, and obesity. Brain stimulation is vastly different when a person engages in a conversation rather than in repetitive games and puzzles. Carrying on a conversation, whether in person or virtually, is far more stimulating and challenging to the brain’s regions.

Conversation with other people chemically evokes neurotransmitters and hormones, which translates into increased feelings of happiness and reduced stress through purpose, belonging, improved self-worth, and confidence. It turns out that being human is undeniably an experience at its most healthy when shared, and a mentally healthy person is prone to stay more cognitively capable.

The Importance of Human Connection to Decrease Dementia

Maintaining this human connection can be challenging, particularly if you are one of the many Americans who are opting to age in place. In the first place, aging is replete with reasons to reduce activity and become isolated when facing particular types of stressful events common to later life years. Role changes associated with spousal bereavement through death or divorce, household management, social planning, driving, and flexibility all fall prey to functional and cognitive limitations. Without the benefit of an involved family or social prescription, it is easy for an aging adult to spiral into social isolation, loneliness, and depression, all of which are causally linked to cognitive decline.

If you or your aging loved one actively chooses to live alone, it is imperative to maintain a vibrant social life. Staying cognitively healthy is associated to satisfying social engagement as well as physical activity. If you live alone, reducing the risk of developing dementia will allow you to continue living out your years as imagined, with independence and control, thanks to your continued human interactions.

If you have concerns about your current living arrangements (or those of a loved one who needs care), please reach out. We help families create comprehensive legal plans that cover care and financial concerns. We’d be honored to speak with you. Please contact our Ruston, LA office at (318) 255-1760. We are happy to help.

 

Are You Considering Having Your Loved One Needing Care Live With You?

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Aging in place continues to increase in popularity, but what should you do when you notice an older loved one is having trouble living safely at home? Troublesome signs like a dirty home in poor repair, unpaid bills, piles of mail, and food out of date or spoiled in the kitchen, poor personal hygiene, and trouble managing medications are all warning signs that your senior is struggling. When visiting, you may notice a loss of weight, disoriented behavior, or lonely and depressive behaviors. When these signs reveal themselves to you, it is time for your older relative to move in with you or into some senior living community where the situation is safer.

Even before the pandemic, polls began showing a shift to the living trend of a century ago, when most seniors lived with their adult children in a multi-generational house. The American Association of Retired Persons (AARP) reports that older parents are moving in with their adult children and comprising a larger component of shared living than a generation ago. AARP states, “Today, 14 percent of adults living in someone else’s household are a parent of the household head, up from 7 percent in 1995.” And with many Americans now working from home, keeping a watchful eye over a parent is easier than ever.

If you consider moving your loved one into your home, there are several things to consider before making a move. For example, you might think the idea is fantastic, but how will it affect other current household members, spouses, or children? Does everyone get along, or will you be importing conflict? Are your lifestyles compatible regarding quiet hours, entertaining guests? Is smoking a habit of someones that needs consideration? Is your home big enough, or will someone have to give up their room?

Is your home suitable for the needs of your loved one? Can they be housed on a single floor without having to use stairs? Can your parent bring their familiar belongings and furniture with them? Perhaps it is feasible to create a “mother-in-law” apartment with a separate entrance or invest in a backyard cottage, the so-called granny pod. If they reside in your active home, what modifications can you make to create a safer environment? Things like night lights, the removal of area rugs, or adding grab bars in the shower or an additional handrail on the stairs can make big safety differences.

Who will be tasked to help your parent? The fact that your parent now lives with you should not mean you are at their service all of the time. Many well-meaning adult children make this mistake. At the outset of living together, a parent is usually fairly self-sufficient. Still, in time they will require more, and if you do not begin your living experiment employing outside help, you will fall into a trap where your time is no longer your own. Share tasks with other family members and make them do their part. Find local senior support services and check out professional in-home care to ensure your loved one becomes accustomed to others providing support to them.

If not in your home, where will your loved one go? Living in a family multi-generational home isn’t for everyone. Your parent might prefer “shared-living” adults living under the same roof but not romantically involved, a sort of roommate experience. Or perhaps a retirement community with defined living stages, from independent to assisted, and full-time care. Many families find living together can save money but not necessarily sanity and look to house their parents out of direct living contact. Talk it out as a family. Even if the conversation is difficult to have, it is better than responding to a catastrophic fall or illness, forcing a change of housing for your parent.

Find out how your aging loved one feels about the next step when they will no longer be able to live alone. Your parent’s thoughts may surprise you. It can help to speak with an elder attorney to address issues that invariably present themselves. If your parent sells their home, how will they handle the profit? Should you want a monthly living expense contribution? Can you claim your parent as a dependent on your tax return? Your parent may no longer have to pay bills but may have other assets and policies to manage; who will handle asset management and premium payments? Goodwill goes a long way to a successful living arrangement but so does preparedness. Having pre-set a structure to address issues will allow you to focus on enjoying your time with your loved one.

If you have questions or would like to discuss your personal situation, please contact our Ruston, LA office by calling us at (318) 255-1760.

Options to Afford Long-Term Care

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According to findings, the US Department of Health and Human Services (HHS) estimates that approximately seventy percent of retirees in America will need long-term care (LTC), with median annual costs for these services ranging from $53,768 to $105,850 in 2020, according to research from Genworth. HHS also reports that those who receive Medicaid-financed nursing home care will spend more time in residence than those who self-finance their care or have private long-term care insurance. These long-term care services and supports (LTSS) are becoming more critical as retirees live longer lives and worry about outspending their assets.

The Dilemma of Affording for Long-term Care

Paying for long-term care planning remains a significant challenge for most older Americans and preparing for service payments can be tricky. LTC insurance may cover a portion of services or all of them, and premiums depend on a person’s age, gender, health, location, and other criteria. The American Association of Long-Term Care Insurance lists 2021 average premiums for initial benefits of $165,000 (with a 1 to 5 percent annual growth rate) for a healthy fifty-five-year-old male to be between $1,375 to $3,685 per year. For the same coverage type, a healthy fifty-five-year-old woman can expect to pay between $2,150 to $6,400. Premium hikes tend to be costly because metrics used years ago in the insurance industry were faulty and did not accurately project the real LTSS costs.

What is Hybrid Long-term Care Coverage?

A different payment option is hybrid long-term care coverage. These policies are part annuity or life insurance and part long-term care coverage. You may purchase a policy upfront eliminating any future risk of premium increases, and your heirs may receive a death benefit if you do not need long-term care. This option is an arbitrage approach hoping that you will not require LTSS and that your heirs may benefit. Hybrid policy price comparisons are more difficult to ascertain than a standalone long-term care coverage policy.

How to Utilize a Health Savings Account to Pay for Long-term Care

A third option is for those retirees with sizable health savings accounts to use pre-tax funds to cover long-term care expenses or premiums. Currently, those itemizing deductions can write off long-term care expenses above 7.5 percent of their adjusted gross income on their taxes. Finally, those low-income retirees with assets below a certain threshold may qualify for Medicaid LTSS. Applicants must pass a five-year “look back” period to assure they did not gift or spend down assets to qualify. If you think you may qualify, take this Medicaid eligibility test.

Typically, family members play an important caregiver role in their loved ones who need help regarding activities of daily living. This statement is particularly true in the earlier stages of requiring care, where someone may need help with just one activity of daily living. In-home assistance, community programs, and residential facilities can help your loved one stay as active as possible, accomplishing everyday tasks. The family-style approach constitutes most living arrangements for those who receive long-term care.

HHS

Many available resources help older adults continue to reside in-home and participate in their communities. The stay-at-home option in the earlier stages of a significant long-term need, or if projected care requirements may be a matter of two to three months, may be the most viable and cost-effective solution. Pivoting to in-home service provision is the most likely scenario for most American retirees. Nursing home residential space is expensive, and Medicaid can only supply so much aid. While most LTSS stays remain paid care and have relatively short durations, the lifetime risk for expensive out-of-pocket costs runs high.

Unfortunately, receiving paid LTSS care is not equally distributed among the US population. Generally, people with limited education and less financial resources are the most likely to experience severe LTSS needs. Over a lifetime, however, the more well-educated population with different socioeconomic advantages tend to live longer and can outlive their assets. Family is an integral part of the solution for long-term care while the federal government responds to the growing need to make this care more available and affordable. For your best outcome, be proactive in your planning. Most Americans will need LTSS, but few will have taken steps to plan for it. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your long-term care needs.

 

Tips to Safely Store Your Financial and Legacy Information

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It is crucial to store your estate planning documents like your will, living wills, powers of attorney, trusts, medical directives, and financial information securely somewhere your survivors can easily access. Additionally, you need to securely store information about birth certificates, marriage licenses, even divorce decrees, as well as medical records and property titles.  In your project, include recurring bills, digital assets, including computers, devices, social media, online storefronts, and smartphone passwords, which you want to keep accessible for your survivors.

Many people are attempting to become as paperless as possible and storing the data onto memory sticks or an external hard drive. Still, others are opting to use online data storage services that keep this information in the cloud. There are still those individuals who prefer maintaining this information themselves, in their homes, and a copy in a safe deposit box.

How you choose to store your relevant data is indicative of the amount of labor and time you are willing to invest in creating and maintaining your information system. Going paperless is generally the most convenient, safe, and quickest. After all, much of our information is already in an online format.

But the online option precludes a trusted person from finding clues about your assets’ locations, what bills need payment continuation and what services to close out. LA Times finance columnist Liz Weston quotes a friend regarding organizing your data, “Your frequent flier miles could disappear while your Netflix subscription continues indefinitely.”

Your list depends on the complexity of your circumstances and the age at which you die. An individual lost to a family in their early forties probably has more moving parts and information reflecting their daily life than someone in their eighties who has likely been downsizing and simplifying their life. Changes in circumstances are an illustration of the importance of updating your information because of life changes.

How to Safely Store and Share Your Digital Information

Some of your organizing will include creating digital copies of important documents like social security cards, birth certificates, passports, marriage, and driver’s licenses. Scanning these documents does not make them a legal copy; however, it will be easier to replace lost or stolen documents if you have a copy. It also puts the information in an easily accessible format rather than rummaging through your home to find the document. Of course, the original documents need to be in a fireproof safe or a bank deposit box, while others can be solely in digital form. For a list of hard copy documents and how long you might keep them, look here.

If you are not comfortable using digital devices, ask someone in your family who can help you set up your digital file system and show you the basics. Your documents can travel with you wherever you go, and you can also share this information with others.

Online storage possibilities are many, but the most popular options are Microsoft OneDrive, Google Drive, and Apple iCloud. These services already offer free limited storage in the cloud, and you can purchase an upgrade for additional storage capability.

If you prefer storing documents locally on a physical storage device, you must include a backup plan and run it regularly to keep your information up to date. A Windows 10 computer permits scheduling backups automatically using Windows File History. Simply type <backup> in the search bar and select <Backup Options> from the results. You can also find this location by right mouse clicking Start>Settings>Update & Security>Backup. If you use a Mac, there is also an auto-backup feature. Read about Apple’s Time Machine to back up your files here. This URL explains other methods to employ when backing up and restoring files.

You can also purchase an external USB hard drive for file backups. Look for a 1 or 2 TB drive that can house all of your information and updates quickly. Smaller USB memory sticks also work but are typically limited to 256GB of information, which can be enough for your needs and transport easily if you travel and want to keep your information at hand. These backup methods should have an extra drive to store identical information in a fireproof safe or a bank deposit box.

The truth is safely storing your financial and other valuable personal data is often a combination of these methods and information types. For your loved one to access financial records, they require your personal information such as usernames, passwords, and social security numbers, in addition to account numbers and online site URLs.

If you feel unsure about your ability to organize and safely store this critical data cohesively, talk with an accountant, attorney, or other trusted advisor to create a structure to implement before copying and scanning data. Everplans is an online service that allows you to store your information in their format for a fee or can provide a starting point to understand the scope of this type of project. Do your research first, and then implement your strategy for best results.

Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your planning needs.

Elder Abuse: Why It Occurs and How To Prevent It

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According to the American Psychological Society, elder abuse is the infliction of physical, emotional/psychological, sexual or financial harm on an older adult. Additionally, elder abuse can manifest as intentional or unintentional neglect of an older adult by the caregiver. Elder abuse has a variety of causes. It is important that family members and caregivers of senior adults be aware of the causes of elder abuse in order to prevent abuse and keep senior loved ones safe and secure.

Elder abuse can occur for a variety of reasons and complex issues. Family stressors are one of the reasons elder abuse occurs. Family members who are charged with caring for a senior family member can often become stressed and run-down dealing with the demands of caring for their loved one. In addition, these family members often feel isolated and do not take time to recharge. These factors can lead to elder abuse. A violent family past can also continue to hold on to family members and this can lead to elder abuse. Financial burdens of a multigenerational household can also lead to financial elder abuse.

Caregiver stress can lead to elder abuse. Caregiving can create stress for the caregiver and the care recipient. This stress can lead to potentially harmful situations for the senior adult. If the caregiver is caring for a person who is sick or physically or mentally impaired, this can lead to stress that would cause a caregiver to abuse the care recipient. The caregiver can feel alone or helpless. Caregiving can lead to emotional and physical stress and exhaustion. These feelings can be overwhelming and may lead to elder abuse.

Certain societal issues can lead to elder abuse. Often senior adults are viewed as insignificant or unimportant. This has in many cases lead to the devaluing of this population, making them easy targets from abuse. This can make the senior more vulnerable to elder abuse. This is evidenced by the fact that scams and financial abuse among the elderly population continues to be a major problem.

How can elder abuse be prevented? Education is one way that elder abuse can be prevented. It is important that caregivers and family members be educated about the risk factors and signs of elder abuse in order to prevent it from occurring. It is also important that families and seniors be aware of financial scams that target the elderly in order to prevent seniors from being taken advantage of financially.

Respite care is also an effective way to prevent elder abuse. There are adult day cares and respite care agencies available to provide care for a few hours a week to take stress off of family members or caregivers. Respite care is especially important for those caring for patients who suffer from Alzheimer’s disease or dementia or are severely disabled. This gives the caregivers time to rest physically, mentally, and emotionally. Along with respite care, it is important for caregivers to maintain social contact and support. Often caregivers are thrust into difficult situations for which they are ill prepared. They often neglect social interactions. It is important not to neglect these interactions, and even to seek support from groups or people who are in a similar caregiving situation. This can help to deal with stresses in caregiving.

Counseling is another option for preventing elder abuse. Caregivers and families alike can benefit from counseling. Counseling can help families deal with past issues, as well as dealing with the emerging stress of caregiving.

Knowing the causes of elder abuse and methods of prevention can help keep elders safe. Family members and caregivers should know and be aware of these. Elder abuse is a major problem and solutions must be found to protect our seniors.

If you have any questions about something you have read or would like additional information, please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help.

Tips for Caregiving During a Pandemic

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The Covid-19 pandemic has posed a challenge for caregivers given the demand for these caregivers to be especially prepared for a deadly virus. Caregivers must balance the need for their care partner’s health and balance it with that person’s safety. As the US heads into seasonally extreme weather months, it is prudent to create or revisit existing plans for evacuating a patient or loved one displaced or challenged by tornadoes, blackouts, hurricanes, floods, wildfires, cyber ransomware attacks, even a resurgence of COVID-19.

Suppose your loved one resides in an in-patient facility. In that case, it is important to know what plans and procedures are in place to address whatever crisis, including current COVID-19 protocols and restrictions the hospice, nursing home, retirement community, assisted living operators, and residence may face. You can share that information with your care partner in a general way to assure them there are protocols in place to protect them and what they can anticipate. An open conversation allows you to allay any fears they may have, and there could be many due to the isolating effects of the coronavirus pandemic.

If you do not have a caregiver disaster plan, it is a good time to create one. The plan can address specific seasons as summer plans can differ drastically from winter ones. Write a list of your loved one’s current needs, impairments, and routines, including important identifying information such as a current photo, date of birth, and Social Security number. Include all known allergies, medications, and diagnoses. A short biography that can inform providers of their interests, personality, and background can go a long way, especially if you as the caregiver typically provide their “voice.”

Emergency relocation requires addressing the need to move all assistive medical devices and durable medical equipment. Don’t forget batteries and rechargers! Remember that a proactive early departure during a crisis when cooler heads prevail can reduce stress levels and help you avoid potential difficulties like gas shortages and traffic jams. Does your chosen relocation site have adequate availability of food, water, toiletries, and medication? You can check with the pharmacy before leaving as many will provide early refills in times of emergency, and a host of major retailers offer prescription delivery. If you are remote to your care partner, check with charitable organizations or neighbors to supply donations or meals and provide daily checks.

Suppose you must leave your loved one in the care of an assisted living or nursing home where you will experience limited contact. Below are some recommendations:

  • Make sure the facility has your primary and alternative contact information.
  • Specifically request updates regarding any changes in your loved one’s emotional or physical state.
  • Ask for medical records that document all care they are administering.
  • Communicate with your loved one in any way possible and often, whether by phone, video chat, or any other means to ensure they are as safe as possible.
  • Take detailed notes because it is easy to overlook or forget important details during times of crisis.

Planning for unexpected crises is not easy because how do you create responses for what has not yet happened? However, there are basic strategies to implement that can be amended to fit specific situations as they arise. If the plan includes relocation, be sure to check with local authorities regarding current COVID-19 restrictions. The planning steps you take may seem very small in light of the larger impact of a crisis event, but these steps can provide organization, protection, and comfort in times of great uncertainty. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your long-term care needs.

What Happens When Your Doctor Leaves Your Health Plan?

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A doctor’s visit for most people is an important event. Often, you must explain your ailment quickly and succinctly, trust that your doctor has your best interests at heart and will keep your confidentiality; and make yourself vulnerable and talk about health issues that may be uncomfortable. Having a good relationship with your doctor can alleviate all these issues and can even increase the quality of your healthcare. So, you have a good relationship with a doctor you like, and you find out he is no longer in your health insurance network. Now what?

First, let’s examine why doctors leave health insurance networks. Usually, doctors leave health insurance networks for normal reasons such as retirement or if they move geographic locations. They are professionals, after all, and just as you probably have had to move to a new job, they do the same. Sometimes, there are other more technical reasons, such as if the doctor is unhappy with how the health insurance network conducts business. You’ll most likely be warned ahead of time if your doctor is leaving your network so you have time to plan, however, your doctor and your health insurance provider are not legally obligated to inform you if he is no longer covered. Unfortunately, huge surprise medical bills are all too common and these can leave you financially crippled for years. This is why it is so important when you reach your open enrollment dates each year that you call your doctor’s office and ensure your doctor is still covered under your plan.

So, what do you do if your doctor leaves your network? You may have continuity of care protection, which enables you to retain the same level of care from your doctor, for the same copays and fees, temporarily. If you are a senior who participates in a Medicare Advantage plan, you have the option to leave your health care network if your doctor does and if the network change is “considered significant based on the [effect] or potential to affect current plan enrollees” according to the Centers for Medicare and Medicaid Services guidebook. If you are currently covered under a private plan and are considering switching, it is prudent to call your doctor’s office and ensure they are covered under the new plan you are considering.

What if you can’t switch plans? Often, doctors will allow you to pay cash for your visits. You may be able to negotiate a reasonable cash price with your doctor because they won’t have to bill your insurance, which would save them time and administrative costs. If your doctor’s cash price is relatively expensive, it may still be worth it to you to maintain continuity of care.

If the previous options are out of the question for you, the next best thing to do is just to ask your doctor if they have any referrals. After all, your doctor will know your situation best and how to provide the best care and may know someone else who will be a good fit for you.

Having a doctor you like and trust can be such a relief and it’s always an unfortunate circumstance when your health insurance network no longer covers that doctor. Fortunately, there are ways you can plan for this and methods to make a smooth transition to a new doctor. If you need assistance in this process or have questions about anything you have read, please reach out to our office. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your long-term care needs.

 

Prepare For the Care of Your Aging Parent

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It is essential to prepare for providing care for an aging parent to be successful. Whether you need basic information about eldercare resources and services, are looking for a local agency to provide those services, or have worries about legal documents or how to finance your parents’ care needs now or in the future, the time to begin planning is today.

The American Public Broadcasting Service (PBS) and television program distributor provides an online handbook, Caring for Your Parents, that offers good preparedness strategies. These planning strategies, links, and tools are also transferable for spousal care, other elderly relatives, or caring for a loved one who is chronically or critically ill with significant ongoing needs. The PBS handbook, designed by WGBH Educational Foundation and the MIT Workplace Center, addresses a wide variety of situations and is even appropriate when considering your own needs as you age.

In terms of an aging parent, it all begins with an open and honest conversation. You might be fortunate and know your parents are well prepared for their future, but most Americans will face situations where loved ones will require additional help and resources. If your parents have a solid aging plan with proper legal documents and financial backing, know that you can access that paperwork and account information.

If there is no plan in place, talk with your parents about future changes with appropriate family members. Take small steps to prevent overwhelming your parents, listen carefully, and be prepared for some denial. Discuss living at-home safety, bringing in outside services and caregivers into their home. Also, broach assisted living or nursing homes and if your parents’ have a valid will and health care proxy. Define their healthcare and living needs for the present and the future.

When locating services remember all eldercare is ultimately local, and services vary widely among states and regions. If you care for your elder parent but do not live nearby, look for resources in the state and neighborhood where your loved one lives. Be persistent; no one resource has all the answers. You may receive advice that something cannot happen when in fact, it can. Request an “Information and Referral” (I&R) specialist. These specialists have the proper training to answer a wide range of questions and connect you to services.

Much of your search will be on the internet. Your search can be overwhelming as there is so much information about eldercare, so be sure to use trustable sites for data. The PBS Caring for Your Parents Handbook’s links can specifically help navigate eldercare services and information complexities, whether the needs be moderate or significant.

Aside from identifying and using eldercare services, the Handbook contains information about finances, legal issues, insurance, home care, housing and transportation, health care, activities, and strategies for caregiver wellness. You can cross-reference data you uncover using the AARP online forums, where people share experiences, ask and answer questions, and learn from each other. Or use the AARP search tool entering phrases like “caring for your aging parent” for articles, books, and guides that you can compare with the PBS Handbook.

When establishing a care plan for your aging parents, realize that good intentions can quickly derail without legal documents in place permitting you to make decisions on their behalf. The quality of life and end-of-life care your parents receive is inextricably linked to proper legal documentation. When making plans and acquiring eldercare services, be certain to speak with an elder law attorney who can provide an overview of the aging process from a legal perspective and identify your parents’ specific needs. Health care proxies and living wills will enable you to make decisions based on your parents’ beliefs, values, and wishes when they are no longer able to decide for themselves.

As elder law attorneys, we consult with families on both care and legal needs of family members as the two are closely related and should be considered together. If you would like to discuss your particular needs, we would be honored to speak with you. Please contact our Ruston, LA office by calling us at (318) 255-1760 or schedule an appointment to discuss how we can help with your long-term care needs.

 

Using Tech Sensors in Homes of Seniors: A National Study

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A seven million dollar, four-year study funded by the Department of Veterans and the National Institutes of Health is being executed to accumulate information about senior living behaviors at home. The goal of the study is to monitor and detect health changes in older adults allowing them to live safer and longer in their own homes. The meta-data gathered from the sensors is then distilled using algorithms and artificial intelligence to look for patterns and draw conclusions. This data analysis will enable researchers to observe the inter-relations of various activity patterns and predict the onset of new medical problems.

The study, known as Collaborative Aging Research Using Technology (CART), was developed by a team of gerontologists, clinicians, engineers, computer and data scientists, as well as end-users. Sensors are alert to the presence of the at-home senior, collect real-time data, are unobtrusive, and do not hinder daily life. The platform is open-ended, accommodating new data systems or devices that may be developed in the future. All study participants consent to the use of the data collected. The data is ultimately de-identified and stored on participating universities’ advanced computer centers and are available to the research community.

Sensors track mobility, such as movement between rooms and walking speed. Engagement in social behaviors like phone calls, emails, social media, and outings are monitored. Sleeping patterns and physiologic functions like BMI and pulse are also monitored, as are sleeping patterns. Changes in a senior’s activity norms, like computer use or driving habits, can be early signs of cognitive decline. Changes in their gait and movement may identify frailty issues. Real-time information provides a more objective measure of ongoing health than patient-based recall in a doctor’s office, trying to describe something that happened weeks ago. Lead researcher Dr. Jeffrey Kaye states, “The technologies that we install are designed to detect changes that are basic to people’s daily function and their ability to stay independent.” Dr. Kaye further comments, “With this more objective and much more frequent data, you can determine the true trajectory of change over a short amount of time with fewer people.”

Specifically, CART uses wall and ceiling sensors that can track the amount of time someone spends in a room as well as movement between those rooms and walking speed. Outside door sensors monitor the number of times a study participant leaves their home by tracking the doors openings and closings. A digital scale not only measures weight but body composition and heart rate. A digital pillbox measures adherence to medication regimes through tracking the opening and closing of the pillbox lid. Many participants are excited to get an upgrade to their old watch in the form of a digital wristband that measures daily activities, steps taken, and sleep patterns. Driving sensors installed in participants’ vehicles track how often and for how long the senior is driving. A sleep sensor is fitted underneath the participant’s mattress and can monitor when someone falls asleep as well as moments of restlessness, and time spent in light, deep and REM cycles of sleep. Computer use is audited via an installed software program following a participant’s logins, app usage, and time spent on the device. All of these sensors create an array of information to be studied by CART researchers without using overly intrusive cameras or keylogging.

The Wall Street Journal (WSJ) reports the technology for CART participant homes currently number 50, with a projected 250 homes to be outfitted. Participants include a group of low-income seniors near Portland, the second group in rural Oregon and Washington comprised of veterans, a mostly African-American Chicago based group, and finally a group in Miami who primarily speak Spanish. This study is being closely watched by a group known as Aging in Place Technology Watch. Founder and principal analyst Laurie Orlov feels a system like CART can present a better opportunity to manage patients sent home from the hospital but still require some form of medical and daily living monitoring. Because CART looks for behavioral change that is predictive of an adverse event, it is superior to other monitoring systems that reactively alert observers that someone has fallen.

CART’s mission is the creation of a national research infrastructure using new and evolving technologies as well as meta-data to study aging in place. Detecting subtle, but meaningful, changes in a diverse group of older adults’ shifts in daily living habits provides information to assess and aid healthy, independent aging. The cost of care projections for the growing US aging population is more than 1 trillion dollars by 2050. Medicare and Medicaid programs are the primary payers of health care for those Americans aged 65 or more. Creating safe and successful living scenarios for the elderly in non-institutional settings is one of the few ways to reduce spending while expanding services to a broader population through technology. A system like CART can potentially detect the onset of medical issues that require intervention by a medical professional or caregiver for those seniors opting to age at home.

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