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    Bob Mauterstock

    Doctors, Watchdogs Against Elder Fraud

    By now most of us have heard about Bernie Madoff and the billions of dollars he swindled from people all over the country. But we may not be aware that this type of fraud, on a much smaller scale, is happening around us all the time. And the people who are most often the victims of these crimes are the elderly.

    About 7.3 million older Americans, or one out of every five people over 65 have already been swindled according to an Investor Protection Trust Survey recently released. Recent research from behavior economist David Laibson shows that people tend to make poorer financial decisions as they get older.

    But some states have taken steps to help seniors avoid these scams. Twenty-three states including California, Connecticut and Pennsylvania have enlisted doctors and other medical professionals to be the watchdogs in the fight against elder fraud. Working through the Investment Protection Trust, state regulators are alerting medical professionals to specific red flags that help identify older Americans who may be more vulnerable to investment fraud abuse.

    In routine visits with their patients these doctors are trained to ask such questions as “Who manages your money day-to-day?” or “Do you regret any financial decisions you made recently?” Other questions include, “Is anyone pressuring you to give them money?” or ” Has anyone asked you to change your will or your power of attorney?”

    More than half of the 67 doctors who were involved in a pilot study in Texas discovered that their patients had been approached with phony financial offers. Financial Planners should also become vigilant in their interactions with their older clients. When I was a practicing financial adviser I learned that one of my older retired doctor clients, in the early stages of Alzheimer’s disease, had been contacted by scam artists all over the country. They told him he had won a lottery and he needed to give them his bank account numbers so they could wire him the money. His wife had to finally get an unlisted phone number so they would leave him alone.

    Elderly parents often will not share these occurrences with their adult children because they don’t want to be viewed as incompetent or gullible. Therefore it is important that their children discuss these problems with the parents’ doctors and ask them to use the questions I have listed above.

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    A Breakthrough in Home Care

    Many seniors want to do everything they can to stay in their homes as they get older. But often they need help to handle various responsibilities, including getting to medical appointments, shopping, socializing with friends, preparing meals, and managing things around the house. They usually have two choices to get these services. First, they can rely on family members to help them. This is often difficult if their children are working or are not in the immediate area. Second, they can hire aides to come to the home. But this can be very expensive. Aides often cost $20 an hour or more and many seniors just can’t afford them.

    But a new alternative is emerging. It is a volunteer non-profit organization created by a community to allow neighbors to help other neighbors. Each senior pays a fee to become part of the network. Fees vary by community and services offered . They range from $175 to $900 a year. Community members volunteer to provide most of the services. Discounted fees are available to people with lower incomes.

    Beacon Hill in Boston was probably one of the first neighborhoods to offer such a program. Beacon Hill Village was founded in 2001. To be a member you must be 50 or older and live in communities surrounding Beacon Hill.  Services offered to members include:

    • Referrals to discounted, vetted providers for everything from dog walkers to plumbers
    • A volunteer to assist you in your home or around town
    • Geriatric care management for you or your family members anywhere in the US
    • Preferred access to MGH Senior Health Medical Practice
    • Rides home from a medical procedure that are required by the hospital/doctor
    • Personalized grocery shopping—we will drive you or deliver groceries to your home
    • Discount prescription drug card—complements Medicare Part D coverage
    • Discounts to all providers: Electricians, plumbers, organizers, personal trainers, massage therapists, and homecare specialists

    A similar program was recently set up on Cape Cod. It is called Nauset Neighbors and boasts that “One call does it all”. It is also staffed by volunteers and serves the communities of Brewster,Orleans, Eastham and Wellfleet.

    There are now eight open villages in Massachusetts, including similar groups in Falmouth and  Martha’s Vineyard.  There are currently about sixty others nationwide, over 120 in the planning stages and the numbers are constantly growing. Each village is unique to its area and resources.  Nauset Neighbors is part of the Village to Village Network, whose aim is to exchange information and experience.

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    Namaste Care: Embracing the Most Vulnerable in Nursing Homes

    Namaste Care is a program designed to improve the quality of life for people in nursing homes or assisted living facilities who are agitated, unresponsive or near the end of life. It is often used with people who have advanced dementia. Namaste, is a Hindu term meaning “to honor the spirit within” and was selected to describe a program that brings honor to people who can no longer tell us who they are or cannot care for themselves without assistance.

    Joyce Simard, a veteran elder-care social worker, founded the Namaste program. She was concerned that some residents were too frail or disoriented to participate in group activities in nursing homes. She noticed that they would often sleep or slump in their wheelchairs near the nurses station all day. She said, “ That’s not quality of life. What they really need is someone to touch them in a loving way” She has written a book entitled, The End of Life Namaste Care Program for People With Dementia.

    Namaste Care takes place in a designated space that helps to create a safe and comforting environment for all who enter, including residents, their families and staff. Hand and foot massage, carefully brushing or combing a persons hair, and moisturizing the ladies faces with “Ponds” cold cream, are a few ways that bring pleasure when done with a loving touch. Resistance to shaving that many men display because they do not realize that they need to be shaved disappears when shaving is accomplished the “old fashioned” way with shaving cream and “Old Spice” after shave lotion.

    Scents of the season are used to provide sensory stimulation.  Flowers that are in bloom, like lilacs in the spring, produce smiles as well as the scent of cinnamon in the fall and winter.  Almost everyone will smile when someone is blowing bubbles or may be wearing an outlandish hat!  Moving arms and legs to music helps keep limbs flexible.  Nourishment and beverages are offered throughout the day so that people with a diminished appetite have more opportunities to eat and drink.

    Namaste programs are being incorporated in facilities around the world. On Cape Cod the Epoch Group has made a very big commitment to the concept. It is now used in all Epoch living centers in Massachusetts and Rhode Island. At Epoch Senior Living in Brewster, MA 20 out of 160 residents may be in the program at any one time. A framed statement on the wall of the Namaste room spells out the Namaste Mission: “To embrace our most vulnerable and provide them with a sense of comfort, calmness and serenity because their lives are still relevant.”

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    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.

    Do Not Resuscitate?

    Many of us mistakenly believe that if we have gone to the trouble of having our parents complete a living will and have had an attorney prepare an advance directive identifying a health care proxy for them, we have covered all the bases. But this is not the case!

    Advance Directives and living wills are not accepted by Emergency Medical Services (EMS) as legally valid forms. If a patient has a living will that states that they do not wish to be resuscitated but does not have an appropriately filled out state-sponsored form that is co-signed by a physician, the Emergency Medical Technician (EMT) will attempt resuscitation. This is a little-known fact to many patients and primary care physicians that can cause patients to be resuscitated even if their family has given instructions not to do so. Although this law is currently being evaluated for a constitutional challenge, it is still in place.

    A do not resuscitate document is a binding legal document that states resuscitation should not be attempted if a person suffers cardiac or respiratory arrest. A DNR does not affect any treatment other than that which would require intubation or CPR. Patients who are DNR can continue to get chemotherapy, antibiotics, dialysis, or any other appropriate treatment.

    The DNR documentation is especially complicated since each state has its own specific approved form. The DNR form for residents of the State of Arizona is required to be printed on orange paper or it is not valid.  The Massachusetts form can be obtained from the Department of Health and Human Services and can be downloaded from the here. It provides for a bracelet to be applied to the patient’s wrist.

    It is imperative that you contact your state health and human services department to determine what form is approved in your state. The form must be signed by the health care proxy (sometimes called the health care agent) or a durable power of attorney and cosigned by a physician. It is recommended that the original DNR form be kept in safe place, and that copies be kept in places that will be readily available to EMS personnel.

    Here is a state-by-state listing of where DNR forms can be obtained in each of the 50 states.

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    Research on Aging

    The elderly are often dismissed because of the diseases with which they content force them to be “less” than fully functioning. However, there is a very precise and unique science behind why everything  eventually ages and dies. Understanding what is behind this phenomenon is the first step in combating many of the debilitating conditions associated with growing old.

    I have discovered a list of TED Talks that cover various aspects of aging. Although the following listed TED Talks may not explicitly cover aging as it relates to humans, the talks offer broad glimpses at some of the associated issues and insights.

    Aubrey de Gray, Roadmap to End Aging: Cambridge researcher Aubrey de Grey argues that aging is merely a disease – and a curable one at that. Humans age in seven basic ways, he says, all of which can be averted.

    Gregory Petsko, The Upcoming Neurological Epidemic: Biochemist Gregory Petsko makes a convincing argument that, in the next 50 years, we’ll see an epidemic of neurological diseases, such as Alzheimer’s, as the world population ages. His solution: more research into the brain and its functions.

    Ed Ulbrich, How Benjamin Button Got His Face: Ed Ulbrich, the digital-effects guru from Digital Domain, explains the Oscar-winning technology that allowed his team to digitally create the older versions of Brad Pitt’s face for The Curious Case of Benjamin Button.

    Dean Ornish, Your Genes Are Not Your Fate: Dean Ornish shares new research that shows how adopting healthy lifestyle habits can affect a person at a genetic level. For instance, he says, when you live healthier, eat better, exercise, and love more, your brain cells actually increase.

    Dan Buettner, How to Live To Be 100+: To find the path to long life and health, Dan Buettner and team study the world’s “Blue Zones,” communities whose elders live with vim and vigor to record-setting age. In his talk, he shares the 9 common diet and lifestyle habits that keep them spry past age 100.

    Rachel Sussman, The World’s Oldest Living Things: Rachel Sussman shows photographs of the world’s oldest continuously living organisms – from 2,000-year-old brain coral off Tobago’s coast to an “underground forest” in South Africa that has lived since before the dawn of agriculture.

    Anthony Atala, Growing New Organs: Anthony Atala’s state-of-the-art lab grows human organs – from muscles to blood vessels to bladders, and more. At TEDMED, he shows footage of his bio-engineers working with some of its sci-fi gizmos, including an oven-like bioreactor (preheat to 98.6 F) and a machine that “prints” human tissue.

    Eva Vertes, Meet the Future of Cancer Research: Eva Vertes – only 19 when she gave this talk – discusses her journey toward studying medicine and her drive to understand the roots of cancer and Alzheimer’s.

    Ray Kurzweil, The Accelerating Power of Technology: Inventor, entrepreneur and visionary Ray Kurzweil explains in abundant, grounded detail why, by the 2020s, we will have reverse-engineered the human brain and nanobots will be operating your consciousness.

    Martin Rees, Is This Our Final Century?: Speaking as both an astronomer and “a concerned member of the human race,” Sir Martin Rees examines our planet and its future from a cosmic perspective. He urges action to prevent dark consequences from our scientific and technological development.

    Take a look!

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    PERMISSION TO REPRINT:
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    Financial Advisors may reprint any articles from The Gift of Communication Blog in your own print or electronic newsletter. But please include the following paragraph:

    Reprinted from Bob Mauterstock’s The Gift of Communication Blog. Subscribe at http://www.GiftofCommunication.com  and receive Bob’s Family Meeting Checklist Guide.