elderly Parents

    Elder Abuse

    Many elderly people rely entirely on family or other trusted individuals to help them. Whether it is for physical needs or emotional needs, as people grow older they tend to need more and more help from others. This dependence on caregivers or family members makes an older person more vulnerable to abuse.

    For example, an older person relying on her children to provide meals and transportation and help her with financial decisions finds it difficult to complain when one of her children takes advantage of her. If for instance, the child takes her money, hits her or neglects her care, the parent may be threatened with loss of support from the child if the parent complains. The child may also use threats of violence to keep the parent in line.

    It is estimated that 5% to 10% of elderly Americans are suffering abuse. Much attention has been focused on abuse in nursing homes, but most of the elder abuse in this country is at the hands of family members or other caregivers in the home.

    Signs of Abuse:

    • Unexplained bruises, welts, fractures, abrasions or lacerations
    • Multiple bruises in various stages of healing
    • Multiple/repeat injuries
    • Low self-esteem or loss of self-determination
    • Withdrawn, passive
    • Fearful
    • Depressed, hopeless
    • Soiled linen or clothing
    • Social Isolation

    All states have agencies that receive complaints of abuse. In some states failure to report abuse of the elderly is a crime. To contact an abuse complaint department, call your local area agency on aging. To find an area agency on aging in your area, visit http://www.longtermcarelink.net/eldercare/ref_state_aging_services.htm

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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.

    Solve Family Disputes with Elder Mediation

    Mediation is the process of bringing two or more parties together who are seeking to resolve a conflict. The mediator’s role is to facilitate communication between the parties and help them discover a solution. The mediator’s job is not to solve the problem or impose a solution.  The process is completely voluntary, and any of the parties can withdraw at any time.

    Mediation can be very helpful in dealing with issues that adult children and their elderly parents face every day. Is it time for the parents to sell their home and move into an assisted living facility? Which child should provide care if a parent wants to stay in their home? How much care does a parent need? Is there disagreement among siblings as to what to do?

    A good mediator will not place blame or responsibility on any one party in the mediation. Through a process of asking questions and soliciting discussion, the mediator will help the parties come up with a solution that works for them. The mediation will not work unless all parties agree that the solution is appropriate.

    In the past, most mediation was done only by attorneys. A new field is developing now which allows professionals from other fields such as Geriatric Care Managers, Financial Planners, and Clinical Social Workers to become mediators. Each state has specific requirements for individuals to be classified as mediators. Check with your local senior center, council on aging or the Internet to find mediators in your area.

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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.

    Still Alice

    A number of books have been written by family members who observe the deterioration of a loved one or friend who has Alzheimer’s. But Still Alice by Lisa Genova is the first book I have read which describes the experience of losing one’s memory through the eyes of the individual herself. This incredible novel is Lisa’s first work. She has a Ph.D. in neuroscience from Harvard. Her extensive research is clearly evident. Not only did she work with professionals in the field but through the Dementia Advocacy and Support Network, she spoke daily with people suffering from Alzheimer’s.

    Still Alice is a novel narrated by the main character, Dr. Alice Howland, the eminent William James Professor of Psychology at Harvard University. Alice is an expert in psycholinguistics who begins to notice strange things happening to her. While she is on a run in her Cambridge neighborhood she finds herself lost and confused. Through her eyes, we experience her decline from a noted scholar to a woman who does not know her husband and children. It is a frighteningly realistic journey. As the son of an Alzheimer’s patient, I can clearly identify the behaviors she begins to experience.

    In addition to her own behavior, we observe the devastating impact the disease has on her husband and adult children. Plans made when she is first diagnosed become a shambles as the family is shocked by her swift decline. Lisa Genova also stresses the importance of support groups not just for families of Alzheimer’s patients but for the patients themselves. There are very few outlets for these people to the share the fear and confusion they experience. We are often more concerned with the family’s expression of grief and overlook the patient’s own reality.

    I strongly recommend this book to anyone who has any contact with an Alzheimer’s patient. it will give you a much better understanding of what it is like to stand in their shoes. Nothing I have read evokes such powerful emotion and insight.

    In 2014, the book was made into a major motion picture starring Julianne Moore as Alice.

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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.

    VA Program pays for Mom and Dad’s Long Term Care

    Looking for a way to help Mom and Dad pay for home care or assisted living? Perhaps you are their caregiver. Wouldn’t it be nice to receive some extra income to help you provide their care? There is financial help available for senior veterans and their spouses.

    For veterans who served during a time of war or for their surviving spouses, the Veterans Aid & Attendance Pension will pay additional income to cover long-term care costs. The great news about this program is that the VA will allow veterans’ households to include the annual cost of paying any person such as family members, friends or hired help for care when calculating the Pension benefit.

    In 2017, Pension can provide an additional monthly income of up to $2,127 a month for a couple, $1,794 a month for a single veteran or $1,153 a month for a single surviving spouse of a veteran. This money can be used to help pay the cost of home care, adult day services, assisted living or nursing home services.

    In order to reduce income to meet the income test for pension, a rating for “aid and attendance” or “housebound” is crucial. Not only does the rating significantly increase the benefit amount but without a rating, room and board costs for assisted living are not deductible for purposes of reducing income. Only the much smaller assisted living medical costs are deductible.

    For home care, non-medical costs are only deductible if the in-home attendant is licensed for healthcare in that state or if there is a rating. Since the non-medical costs for home care represent the bulk of all costs for long-term care at home, without a rating, those households with a non-licensed attendant would not qualify for the benefit. Examples of medical or nursing services at home would be things such as help with activities of daily living such as dressing, bathing, toileting, ambulating, feeding, diapering and so on. Other services might include medication reminders or supervision necessary to provide a protective environment for the care recipient, as in the case of dementia or Alzheimer’s.

    A rating for aid and attendance is automatic if someone is a patient in a nursing home or that person is blind or so nearly blind as to need assistance.

    It is our understanding that a non-licensed in-home attendant could be just about anyone receiving pay for providing services. This might be members of the family, friends, or someone hired to live in the home. Unfortunately, a spouse cannot be included in this list for reimbursable caregivers.

    For a disabled person who has been rated, a family member will be considered an in-home attendant, but that family member has to be paid for services duly rendered. There is potential for fraud here where a family member may move into the home and ostensibly receive payment as a caregiver but not actually provide the level of care paid for. Documentation for this care must be provided to VA, and it is reasonable for VA to question whether the services being purchased from a family member living in the household are legitimate. Such arrangements should be extensively documented.

    Refer to the Veterans’ Administration Geriatrics and Extended Care program for additional information.

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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.

    Keep Your Parents Safe In Their Home

    Generally, elderly parents want to remain living in their own home. However, remaining in the home becomes a concern when children see their parents slowing down, perhaps even having trouble with handling stairs and doing general daily activities.

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

    The Bureau of Labor Statistics states:

    “Employment of personal and home care aides is projected to grow by 51 percent between 2006 and 2016, which is much faster than the average for all occupations. The expected growth is due, in large part, to the projected rise in the number of elderly people, an age group that often has mounting health problems and that needs some assistance with daily activities.” Bureau of labor Statistics-Occupational Outlook Handbook, 2008-09 Edition

    This growing need for aides and services also encompasses:

    • home remodeling services — making a home more serviceable to the elderly;
    • safety alert systems and technology;
    • motion sensors to monitor movement;
    • telehealth services — using home-based computer systems for the doctor’s office or a nurse to monitor vital signs and
    • even a pill dispenser that notifies when it is time to take medication.

    Where do you begin to make sure your elderly family member is safe and managing well in his or her home?

    • Visit often and at different times of the day and night.
    • Make note of daily activities that appear challenging and where changes might be made to add safety and convenience.
    • Remove rugs that slide — causing a fall — and move furniture with sharp edges.
    • Set the water heater at a lower temperature. This will protect their older sensitive skin from scalds and burns.
    • Be sure smoke detectors and carbon monoxide detectors are in place.
    • Bathrooms are a hazard area for the elderly. Grab bars by the toilet and shower are a must to help prevent falls. There are easy to install bars at your local hardware store if you want to do the work yourself.
    • Another item that is good to have is a shower stool or chair.

    If you are not sure of what needs to be done, consider hiring a professional. There are companies that specialize in home remodeling and accommodation for seniors. Michelle Graham of Accessible Design by Studio G4 says about senior home remodeling projects:

    “The main thing we incorporate in all of our projects is a careful study of needs and potential needs that may develop throughout a client’s lifespan.”

    Keep in mind what future home adjustments might be needed for your parents to “age in place” in their home.

    Home safety or medical alert companies provide GPS-based bracelets or pendants to track the elderly at home who tend to wander. Or the companies may provide alarm devices, such as pendants or bracelets, which allow the elderly to alert someone if there has been a fall or a sudden health-related attack. In the event an alarm has been triggered, a 24-hour monitoring service will alert the family or medical emergency services or call a neighbor depending on previous instructions. In addition, there are companies that will install motion sensors in the home to monitor the elderly on a 24-hour basis.

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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.