Assembling your support team

Much as we would like to imagine an elderhood free from troubles, the truth is, we are all likely to need help eventually. And on several levels.

Informal support. This is the kind of help that friends and family members can provide short term. Someone to run errands or mow the lawn, etc. Make a list of the

  • people you feel emotionally close to
  • people who live close by who are reliable

When the going gets tough. If you were hospitalized, who would you call to

  • make medical decisions for you if you were unable to speak for yourself
  • pay bills or perhaps even manage your financial affairs long term

Your health care team. Medically trained support:

  • Your primary care provider and any specialists
  • Your pharmacist
  • Allied health providers (e.g., therapists, home health)

Professional advisors

  • An elder law attorney for important documents. You will need an attorney to set up a trust or will for dispersing your assets after you are gone. Or, if you have no relatives, to arrange for a guardian to make medical and financial decisions for you when you can no longer do so yourself. In addition, an attorney can review contracts and catch important details about senior housing. And an attorney’s advice is critical if you are considering a reverse mortgage or spending down your assets to be eligible for Medicaid.
  • A financial planner to manage assets and strategize to liquidate them to pay for care.
  • A CPA to highlight the tax implications in any of the above situations.
  • An insurance broker for prescription, Medicare supplemental, life insurance, etc.

A Geriatric Care Manager. The choices are boggling when it comes to assembling your team. It’s difficult to assess quality of professionals or compare pricing. A Geriatric Care Manager is a “meta-advisor” whose experience can help you choose your team wisely and coordinate whom to call when.

Want help assembling your team? Give us a call at 916-524-5151.

Learn more about our aging life care planning services.

Paying for care at home

How you pay for care at home depends on whether the service is by medically trained staff or by nonmedical caregivers. Also, what you can mix and match in terms of community programs and help from friends and family.

Medicare pays only for care in the home that requires the skills of a nurse, nursing assistant, physical therapist, or other medically trained professionals.

Home care $$–$$$$
The cost of nonmedical home care is NOT covered by Medicare. As a result, you must contract directly with providers. Fees depend on how many hours a week your care requires.

Consider that caregivers coming to your home need a livable wage. Add to this agency costs of staff recruitment, vetting, training, and scheduling. The price can mount up quickly.

  • Long-term care (LTC) insurance. These policies can be purchased privately and are the least expensive when begun in middle age. Typically, to draw upon the insurance, you must pay for home care services out of pocket for a waiting period. Insurance will contribute afterwards and pay up to the lifetime cap. Check policy details.
  • Veterans assistance. For qualifying vets who saw active duty with at least one day during a war, there may be benefits available to help with the costs of home-based care.
  • Personal savings. Consult with a financial planner and elder law attorney to determine the best strategy for liquidating assets to cover your care.

Adult day care $–$$$
You must pay privately. Many programs are run by nonprofits so are underwritten by donations and grants. Medicaid, LTC insurance, and veterans benefits may also help.

Home health and hospice $

  • Medicare. This is typically deducted from your Social Security check and will cover home health services (80%) and hospice (often 100%).
  • Supplemental insurance. This is insurance you buy to cover the 20% balance not paid by Medicare.
  • Medicaid. Those with VERY low income and minimal assets may qualify for state government support. The eligibility requirements are stiff. Coverage includes 100% of most medically trained care, with some restrictions. Coverage for nonmedical care is spotty and varies by county.

We can help you sort out your options. Give us a call at 916-524-5151.

Learn more about our aging life care planning services.

Medical emergencies: Are you prepared?

Judy fell and broke her hip. She calls 911. She lacks a medication list. As a result, the hospital team is unaware of her chronic conditions. Her daughter lives far away and doesn’t know if she should fly in.

Accidents by their very nature are unplanned. That doesn’t mean you need to be unprepared for a fall or a serious incident (e.g., a heart attack or stroke).

Those who are prepared and have a professional advocate, such as [tacm], are more likely to get the care and the outcomes they desire. Plus, they can recuperate in a setting most in line with their personal needs and preferences.

To be prepared, you need

  • current documents. Key to avoiding problems is the ability to give emergency and hospital personnel a list of current medications, your medical history, and an up-to-date list of your doctors and their phone numbers. Copies of all your insurance cards will speed the clerical side of the process. You will also need an advance directive that names your health care decision maker(s) and your preferred treatments.
  • up-to-date decision makers. Does the person you have chosen know and understand your treatment preferences? Does the rest of the family know and respect that he or she “speaks for you”? Does your decision maker have a medical background? Is he or she nearby enough or able to drop everything and come to your side?
  • a professional advocate. Often family or trusted friends cannot be present at a moment’s notice. And most people are not conversant with medical procedures. A professional advocate, such as a Geriatric Care Manager, has met with you prior to the emergency. He or she can fill in the medical team and communicate your personal priorities. A Geriatric Care Manager can advise decision makers by providing insight about treatment choices: Pros and cons and likely outcomes vis-à-vis your values. A Geriatric Care Manager can keep long-distance relatives informed and make recommendations regarding the need to travel. When it’s time to leave the hospital, a Geriatric Care Manager can recommend the best support facilities on the basis of your resources and personal preferences. As you plan ahead for emergencies, you will want to make decisions about hiring a professional advocate. Some Geriatric Care Managers offer the option of 24/7 emergency, on-call coverage. Others do not.

Ideally, all this information is available on your person or is readily accessed should you get into an emergency situation.

Want help getting prepared for a medical emergency? Give us a call: 916-524-5151.

Learn more about our aging life care planning services.

What is a Geriatric Care Manager?

Imagine your life as a movie. If you are the director, a Geriatric Care Manager is your production manager.

He or she is a deeply knowledgeable guide (usually a nurse, social worker, or allied professional) who finds you high-quality help, arranges care “locations,” and advises you about needed services.

Geriatric Care Managers are part of a national organization with training requirements, codes of ethics, and a nationwide network of experienced colleagues in case you need to move to a different part of the country.

Specialized knowledge and skills
Aging affects all aspects of life, so a Geriatric Care Manager draws upon many areas of expertise:

  • Advocacy. Communicating with doctors and navigating the very confusing eldercare network to get you the care you want.
  • Health and disability. Conducting an assessment and making recommendations so you and your family members can rest assured that a plan is in place if you need extra help.
  • Local resources. Recommending area service providers. Anyone can Google. But a Geriatric Care Manager intimately knows quality and reputation and can match best services for your budget and priorities.
  • Family. Helping relatives understand their role and work together to support your wishes.
  • Housing. Providing recommendations for the best fit based on your needs, priorities, and resources. No charge to you for this service. Referral fees paid by the facility.
  • Legal. Assembling needed paperwork and referring you to reputable attorneys as needed so you are well covered by a professional team.
  • Finances. Reviewing your options to identify eligibility for programs and ways to stretch your dollar wisely.
  • Crisis support. Helping you create a safety net you can depend on in emergencies.

As the director of your later years, how do you want your story to unfold? While not all of it is within your control, you do have agency. With planning, there is much you can do ahead of time to prepare for the elderhood you want and create a network to support it.

Would you like a guide for aging well? Give us a call at 916-524-5151.

Learn more about our aging life care planning services.

Types of long-term care

While “aging in place” has its benefits, it is expensive to get such individualized care. Plus, it’s rather isolating. Group options require a move, but are more social and cost effective.

  • Assisted living. People move to assisted living when they are ready to stop cooking, cleaning, and maybe even driving. They enjoy social activities but need more help than an independent retirement community might offer. Though not a setting for people with advanced dementia, a portion of assisted living residents may have memory problems.
  • Memory care. With activities specifically for people with significant dementia, memory care may be housed in a wing of assisted living or operate as an independent facility.
  • Skilled nursing or “rehab.” Geared for short stays—several days to several weeks—a skilled nursing facility can be thought of as a place to get stronger or learn to do things in new ways after a setback. Then you move to a more homelike environment.
  • Nursing home. This setting is a long-term version of rehab but for those with complex conditions who don’t need a hospital, yet aren’t independent enough for assisted living.
  • Continuing care retirement community (CCRC). This large “campus” offers all of the above and more. Move in while fully independent and able to enjoy the pool, golf course, etc. As care needs change, residents move to the different care buildings yet stay on the same property. Ideal for a couple when one needs more support than the other.

Let us help you understand the different options. Give us a call at 916-524-5151.

Learn more about our aging life care planning services.

Home care

Support is available for those who wish to stay at home. However, one-on-one care is expensive. And it’s not always easy to find caregivers. Community services can sometimes be patched together.

To stay at home, it helps to have a knowledgeable person check in periodically who knows eligibility requirements and can supervise and coordinate all the players.

  • Home care. People who do not need medical attention, but simply help with household activities, running errands, or light companionship, benefit from home care. The key to success is finding a good match between the caregiver’s personality and your own.
  • Adult day care. If someone is available for nighttime care of a person with dementia or light medical needs, then adult day care can provide engaging daytime activities, meals, and relief for the caregiver. Ideal for working families or a spouse who needs a break.
  • Home health. Patients are able to leave a skilled nursing facility yet continue receiving needed therapy through visits at home. This is a short-term service, ending when the patient has improved as much as can be expected.
  • Hospice at home. Hospice is for people with a life expectancy of up to six months who opt for improved quality of life over the hardships of treatment. Nurses visit at home a few times a week to monitor pain and comfort and to support families as nature takes its course.

Call us at 916-524-5151 to start the planning process for aging in place.

Learn more about our aging life care planning services.

VA Aide and Attendance and Social Security Increases – 2020

Did you know Cost of Living Allowances (COLA) for VA Aide and Attendance and Social Security is now at 1.6%? For Social Security you should receive a statement regarding your benefit. There is also an increase in Medicare. Pay attention to your statement. Most will be paying $145 Plus starting 1/1/2020. This will come into play if you are also receiving the VA Aide and Attendance.

The 2020 increase for Aide and Attendance is as follows:

  • Married Veteran and Spouse; $2266.00 monthly, $27,195.00 Annually
  • Single Veterans; $1952.00 monthly, $22,939.00 Annually
  • Widow of Veteran; $1229.00 monthly, $14,742.00 Annually

Have you ever wondered whether you’re eligible to receive public assistance like Medi-Cal, Social Security, or Veteran’s assistance Benefits like the VA Pension Fund? Well I host FREE seminars that cover how to receive many different types of public assistance. 

To Find Out More, Go To: http://www.advancedwellnessgcm.com/seminars/

Honoring Veterans

With Veterans Day coming up, you might be wondering how you can show your appreciation to the veterans in your life and community. There are plenty of large and small gestures you can take to make a veteran’s day and to perform an act of kindness. Here are 4 thoughtful ways to honor Veteran’s Day and all those that serve our country.

Donate to a Veterans’ Charity
If you’d like to help out but don’t have the time to volunteer, you can always make a donation to a reputable organization that represents veterans With more than 40,000 U.S. charities dedicated to assisting U.S. veterans, you might not know which one to choose. Consider donating to a charity that helps out veterans in your area, or perhaps offer funding to organizations that provide support on a nationwide level.

Take Part in the National Two Minutes of Silence
Whether you’re at work, at home, or in your car, you might consider taking a few minutes to silently reflect on the impact members of the U.S. armed forces have made in the country. If there are any veterans who mean a lot to you, take your time to reflect on your gratitude for these special individuals. This two-minute period takes place at the same time nationally, but different times depending on individual time zones.

Wear a Poppy
Veterans Day is a significant day for former members of the U.S. armed forces. Many veterans wear hats, pins or uniforms to share their pride in their service. If you are not a veteran but want to support the veterans in your community and around the country, you can wear an American flag pin or red poppy to show your gratitude for these service members. You might be wondering what the significance of the red poppy is. Its connection to Veterans Day comes from the famous World War I poem “In Flanders Fields,” in which the red flowers were the first to bloom in the fields after battles in France and Belgium. Poppies are also considered a symbol of appreciation for veterans in various European countries.

Send a Gift to a Veteran
One way to show your gratitude to a veteran you know is by sending them a thoughtful present. You might decide to bake them a fresh batch of their favorite cookies or get them a gift card to their favorite restaurant. Maybe you’d rather give them something that will brighten up their home? A nice selection of Veteran’s Day flowers bring color and life to any home. When you send someone a bouquet of flowers, you will show your gratitude for their service. When they see their bouquet out of the corner of their eye, they will think of your kindness.

When to Have the Talk About Hospice

Hospice care, as defined by the National Hospice and Palliative Care Organization is “quality, compassionate care for people facing a life-limiting illness or injury…involves a team-oriented approach to expert medical care, pain management, and emotional and spiritual support expressly tailored to the patient’s needs and wishes”.

The earlier you have the conversation about bringing in hospice care, the better. When given a prognosis that doesn’t clearly indicate a specific survival time (such as Congestive Heart Failure or advanced cancer) but is a life-limiting illness, your loved one may think they have longer to live than they actually do and not be ready to admit that hospice care is an option. Respecting this uneasiness doesn’t mean you shouldn’t discuss it. And one of the benefits is that hospice helps families to deal with the grief and anger and denial through the counsel of social workers and chaplains.

How to actually have the conversation includes the following:

Be understanding of your family members’ feelings. Fear and grief are very personal and each person expresses them differently. Patience is needed by you so that they can become ready to talk about hospice care.

Include family members in the conversation, and respect the wishes of your relative if they say they don’t want specific family members present. Those who have been caring for the relative in the home should be part of the conversation from the beginning.

Don’t expect a decision immediately. There may be questions and a request to think things over. Allow your relative the time to adjust to the idea. As their illness progresses, you can introduce the hospice option again.

Convey to your loved one that you truly want them to have the best care possible. You want to bring in hospice care to help ease their pain and offer additional support and guidance through this last phase of their life.

It’s not an easy conversation to have, but if you approach it with patience and kindness, it can help make the experience of bringing in hospice care more comfortable for you and for your loved one.

-Helen Justice

Have you ever wondered whether you’re eligible to receive public assistance like Medi-Cal, Social Security, or Veteran’s assistance Benefits like the VA Pension Fund? Well I host FREE seminars that cover how to receive many different types of public assistance. 

To Find Out More, Go To: http://www.advancedwellnessgcm.com/seminars/

WORKING SONS AND DAUGHTERS

What happens to your business or work when you get the call Mom or Dad is at the hospital? Are you ready? What are important documents you need before you go racing to the hospital. What happens to your own business and how long will you be absent? Not earning income. 

First, breath when you get the call because you are prepared.  You got this!

Documents you need now:

  • Copy of Health insurance Cards
  • List of Medications and even the new ones
  • Healthcare Proxy – so you can speak on behalf of your parents
  • Advanced Healthcare Directive
  • Power of Attorney

Have a copy of these documents ready in your car or with you. Without these you are not able to speak on behalf of parents. More and more hospitals and health care provider are requiring the right documents. 

You will become the advocate for your parents. You are not at the hospital to make friends; you are there to get your parent the best care for them. The hospital is there to rotate the bed and keep it making money. The sooner one vacates the next person will fill the bed either in the hospital or ER. Don’t assume the discharge planner, social worker or the staff is your guiding light through the doors of hospital or ER. You want to know your options so you can make important decisions. You know best of your love ones not the person trying to do their job rotating the bed. You are not a medical person and it’s fast and confusing the decisions you need to make. Don’t be afraid to ask questions! Ask until you understand because there is a medical language that is foreign to you.  Understand the diagnoses and treatment. Better yet is there surgery needed and you need to know what happens after surgery. 

Listening is the next weapon in your toolbox. Be the extra set of ears for your parents. Take notes when you are talking to the medical staff and doctors. If you don’t understand repeat the questions and ask for them to explain in a different way. 

Who’s at home? Let me explain. Most the time Mom is the caregiver for Dad. Statics show that the caregiver (Mom) will end up in the hospital before the sick person. Who will sit with the Dad that may have Dementia or Alzheimer’s? More and more families don’t have family nearby or they are single child with no siblings. 

How to handle your Job/Business:

This is an emergency call and you need to go fast. You can make calls from the hospital. Or you can have family members call your work. Let you manager/boss know so they can pick up the slack. If you choose to stay at work your focus is gone. Go ahead and work guilt free, we all handle crises differently. Have someone cover your shift, work, or projects. 

  1.  Talk candidly with your boss or manager. 
  2.  Use the Family and Medical Leave Act if you Can
  3.  Ask if your Employer has other Caregiving Benefits
  4.  Change your work hours temporarily
  5.  Consider hiring a Geriatric Care Manager

Having your team of professionals advising you along the way makes it so much easier and less stress. It also helps getting you back to your business or work. Having a working relationship with a Geriatric Care Manager that can be your eyes and ears on the ground. You might not be near your parents and you need someone now. Some pitfalls that happen when not prepared.

  1.  Thinking that my sibling is doing the parent care and I’m off the hook
  2.  Not giving appreciation and emotional support to the main caregiver
  3.  Falling prey to the “killer” misconception that “I shouldn’t have to ask”
  4.  Assuming that our sibling are the same people they were as kids

Think about 8 key areas:

  1.  Family support
  2.  Health safety
  3.  Medial needs
  4.  Cognitive health
  5.  Mobility
  6.  Personal Hygiene
  7.  Meal preparation
  8.  Social interactions

 Finally, think about your own needs and abilities. Does your own health allow you to physically are for someone? Do you live close enough to visit as often as needed? Would you want to live with them, either in their house or yours? Do you have the kind of relationship that allows you to spend a lot of time together without creating a lot of negative feelings on either side? Do you have the personality to provide the type of care they need? Are you willing to learn how to provide that care?

These are just a few of the areas you may not have thought of. Finances on both sides is major concern. You not working and earning income and parents may not have enough assets to handle the emergency. This includes in-home care, board and care, assisted living, home-health, palliative care, hospice, and finally arrangements. A Geriatric Care Manager will be your tool for guidance and recommendations. 

Advanced Wellness GCM, Inc

VIP Concierge Care Management

 VA Accredited Claim Agent (POA #27203)

 Medi-Cal Applications

RCFE Administrator and Instructor USAF Retired