Making Plans for Aging at Home
January 24, 2011
There used to be very few options for seniors who began to have trouble living on their own. In many cases the only options available were to move in with family or move into a nursing home. Now, however, that doesn’t have to be the case. With new advancements in technology, the help of family and local aging services, and with some planning and forethought, many seniors will be able to live at home and on their own for many years. Here are a few things to consider right now if you want to age at home in the future:
Support System- Do you have family or friends nearby who can check on you regularly and help when home maintenance issues crop up? Having someone close to you who can provide you with transportation is helpful as well, although many cities have public transportation services that may be an option.
Home Renovations- Is your home senior or handicap friendly? Are doorways and hallways wide enough to accommodate a wheelchair? Could you easily add ramps or lifts in place of stairs, if necessary? Do your kitchen and bathrooms facilitate easy maneuverability with as little reaching or bending over as possible?
Security or Medical Alert System- Having a security or medical alert system in place can provide immeasurable comfort to an elderly homeowner and his or her family. The technology for this is improving by leaps and bounds, and there are a number of different options available.
In-Home Care Services- The length of time you can remain in your home can be greatly increased if you have the financial means for (and access to) quality in-home care services. Someone to do basic cleaning and cooking, and help with daily activities, can prolong your time spent at home… but you have to plan for it.
Getting older shouldn’t mean you have to give up your home, your friends and neighbors, or your independence. For more information about what you may need to stay in your home as you age check out the website for the National Aging In Place Council.
Just Say No? Medical Marijuana in Nursing Homes
October 30, 2010
The legalization of marijuana is on the ballot in California this November, but California isn’t the only part of the country where marijuana is making news. The use of marijuana for medical purposes is being debated around the nation—especially as concerns elderly patients in nursing homes which receive federal funding through Medicare or Medicaid.
This article on the New York Times’ New Old Age Blog reports on this issue, and just how concerned and confused nursing home facility administrators are about what their options are and how to proceed. “Any patient using medical marijuana breaks federal law. Marijuana is listed as a Schedule 1 drug, which means the federal government considers it to have no medicinal value. Despite this, physicians in 14 states and the District of Columbia are allowed to recommend it. . . Many facility administrators wonder how they can comply with federal law and preserve their reimbursements and at the same time permit residents to medicate with marijuana.”
Federal funding isn’t the only conflict attached to the medical marijuana issue. Nursing homes in New Mexico (a state where marijuana was legalized for medicinal purposes in 2007) report that “the lack of dosing direction has caused problems. . . Pills in nursing homes are in what they call vacuum packs: you have to pop a pill out one at a time. They don’t do that with marijuana. It’s an amount of marijuana in a small plastic bag, so there is no way to track if someone took one or two pinches.”
Another issue to consider is the stigma attached to marijuana use, and complaints from other patients or residents.
Medical marijuana is generally prescribed to seniors to help them deal with chronic pain. Oregon’s long-term care ombudsman, Mary Jaeger, asks in the article above “Wouldn’t any one of us, in our own homes, feel that we have the right to live our lives by our own values and choices, to preserve our own dignity and, frankly, to live pain-free?” Will seniors moving to federally supported nursing homes have to find other ways to deal with chronic pain? And more importantly… will they be willing to do so?
What Matters Most When Choosing a Long-Term Care Living Situation?
August 11, 2010
Elderly people and their families can spend months—sometimes years—looking for the perfect long-term care living arrangement. Most families try to avoid the nursing home option to the very end, believing that assisted living or small residential care homes provide a better quality of life. But is this fact or fiction?
Paula Span in her article on the NY Times New Old Age Blog suggests that “what variety of facility an older person lives in may matter less than we’ve assumed. And that the characteristics adult children look for when they begin the search aren’t necessarily what makes a difference to the people who move in.”
Span’s suggestion is based on (among other things) a recent study published in The Journal of Applied Gerontology, which found that among 150 Connecticut residents living in various long-term care situations (assisted living, nursing homes, residential care homes), the type of living situation itself made little difference in the resident’s emotional well-being. Rather, happiness and contentment was more a matter of “the characteristics of the specific environment they’re in, combined with their own personal characteristics — how healthy they feel they are, their age and marital status.”
Logically enough, a resident of a long-term care facility of any kind is more likely to report satisfaction and comfort if they had a hand in choosing their living situation, if they were part of the decision making process. In fact, it is the process itself—researching options, visiting facilities, considering current and future social and physical needs and how they will be met—that is the beginning of acclimatization.
Whatever your choice, you’ll want to know that you have options for paying for your long-term care living situation. Medicare.gov has published a chart summarizing and comparing the various options for long-term care financing. We find that the chart falls short, however, in the way it outlines the features of “Medicaid”, called Medi-Cal in California, as it does not address planning options that are currently available to qualify for the subsidy and protect your home and other assets. For more on this topic, see our “Consumer’s Guide to Medi-Cal Planning”.
How to Tell If Your Loved One Needs In-Home Care (And What to Do About It)
July 12, 2010
It’s not always easy to know—or to admit—that a loved one is unable to fully care for themselves anymore. The signs develop gradually, and aren’t always easy to pick up on if you see your loved one on a daily or weekly basis. Often it’s the son or daughter who has moved away and comes home for a visit who notices (what is to them) the “sudden decline” in mom or dad’s ability to perform the most basic of tasks.
If you suspect (but aren’t sure) that your loved one may need in-home care, there are a few signs you can look for to help you decide. The “Right at Home” website has an article listing ten signs that home care could benefit your loved one, and Responsive Home Health has a 3 page questionnaire to help you determine whether or not mom or dad is still just fine at home alone. The signs you’ll want to look for include:
- Inability to prepare own meals
- Frequent falls
- Inability to keep up with basic hygiene such as bathing and brushing teeth
- Depression
- Sudden isolation
- And more…
Once you know for certain that your loved one needs in-home care you’ll have to face the sometimes daunting task of finding (and figuring out how to pay for) the right service. A recent article in the Wall Street Journal provides some excellent information on how to find the right kind and level of care for your loved one. For example: does your parent need just a little bit of help with cooking and housekeeping, or is more comprehensive care (such as daily help with bathing, grooming, mobility and medication) necessary? The level of care your loved one needs, as well as what financial resources you have available, will help narrow down your choice of agency or aide.
Always remember, you don’t have to go through any of this alone. There are a number of dedicated professionals who can help you along the way—including our office. Don’t hesitate to seek out help from these professionals. Remember, all of us are here to help.
How to Find the Perfect Senior Living Arrangement
June 3, 2010
When it comes to living arrangements, senior citizens have far more options available to them today than they ever have in the past: independent retirement communities, assisted independent communities, at-home assisted living, at-home nursing care, live-in nursing homes… the list can go on and on. Having all these options available is almost certain to make it easier to eventually find the right living arrangement, but it doesn’t necessarily mean the search itself will be easier. In fact, having so many options and facilities to consider can often make the search that much more confusing.
The search for the right living arrangement—either for yourself or for an aging family member—can be much easier if you know ahead of time the right questions to ask and the important things to look for. This article in U.S. News and World Report shares 9 things to look for in your search for an assisted living facility, including:
- Making sure the facility is licensed
- Ensuring the facility’s financial stability
- Getting referrals
- Making visits to assess the facility’s staff
- Asking what current residents have to say
- Considering whether it can meet not only your current but also your future needs
- Asking about payment options (including Medicaid, called “Medi-Cal” in California)
- And more
Having so many different options these days means we can hope that finding the right senior living arrangement is a much more personal—and pleasurable—task than it has been in the past. Some of the best retirement communities or nursing homes have long waiting lists, so starting your search early will improve your chances of finding the place that’s right for you. But be careful, nursing home and assisted living contracts can contain surprises and should be carefully considered; or better yet, have an attorney look at the contract for you. And, if you are finding a place for your parent or other infirm family member, try to avoid signing the contract yourself unless you plan on being financially responsible for payment. It is often better to ask you parent or loved one to sign the contract and, if they are unable to do so, then sign only as their “agent” if you have valid agency authority.
With the many choices now available there’s no reason not to have exactly the senior living situation you want and need.
Where Can Seniors Find “Home Sweet Home”?
May 3, 2010
Where you live is a defining aspect of your character throughout your life. Your “hometown” often plays a large part in the formation of your character; as adults we decorate our homes to reflect our interests, hobbies and loves; and the neighborhoods in which we choose to raise our children (city, farm, suburb) tell us a lot about our underlying values and where we feel safe and secure.
The idea that where you live is an important part of who you are doesn’t diminish as you get older—in fact, the longer you’ve lived in a place the more it seems to become a part of who you are, and vice-versa—so it’s no wonder that seniors are as choosy about where they live as any of the rest of us. What follows are some of the options for senior living arrangements. What you and your loved one will choose will depend on health, finances, community support, and of course—your family.
Most seniors would prefer to stay in the home they’ve known and loved. A senior or retirement community may look perfectly nice to a son or daughter; but mom or dad may see the retirement community as a first step toward losing their independence and being forgotten. Many senior citizens can stay in their homes for quite some time so long as they have the support of family and community and perhaps the help of an in-home caregiver.
Another option for housing is a senior or retirement community. These are often independent communities which provide age-segregated living opportunities for seniors who are still active. They usually provide social activities, regular transportation around town, and some personal care or nursing services. These communities can be the perfect solution for a still active senior who is unable to drive anymore, but be very cautious when choosing a community; with no regulation or governing body the non-social services they provide can be suspect.
A nursing home is the most drastic option for senior living, and is usually reserved for chronically ill people who need medical care and regulation in addition to help with the most basic of daily tasks. The decision to use a nursing home is a difficult and emotional one, and should not be put off to the last minute. Not only because nursing homes are expensive, and require as much advance financial planning as possible, but also because finding the right nursing facility for your loved one can take time.
Whatever housing option you are looking for, don’t be afraid to ask for professional help or advice. A Geriatric Care Manager, Elder Care Support Services, or an Estate Planning or Elder Law Attorney can help your family make and implement this tough decision.
How to Choose the Right Nursing Home
April 28, 2010
A recent article in the New York Times calls choosing a nursing home for your loved one “one of the hardest [decisions] you will ever make;” and yet it is a decision that almost all of us will have to think about eventually (whether for a grandparent, parent, spouse, or for ourselves.) It is a decision that is made infinitely more difficult if you are forced to make it under pressure.
But choosing a nursing home doesn’t have to be the difficult and unpleasant decision we think it will be, not if you know what to look for, and have the time to really review all your options. Walecia Konrad, author of the article mentioned above, breaks the process down into four steps, and gives valuable advice on how to approach each individual step:
- Doing the research
- Visiting the homes
- Asking the right questions
- Consulting the experts
The home you eventually choose will be a very personal decision based on a number of factors; location, the preferences of your loved one and your family, health, and of course finances; but having all the right information—and confidence in your ability to evaluate that information—is a key part of making this very personal and very emotional decision.
Medi-Cal Budget Cuts Won’t Affect Nursing Home Residents
August 2, 2009
We have received many inquiries from clients and colleagues asking whether the California Budget, just signed by Governor Arnold Schwarzenegger on July 28, 2009, will adversely affect nursing home residents who rely upon Medi-Cal to help pay for care. The good news: No. Neither will it directly affect subsidies for ancillary services, such as dental and podiatric care. The budget cuts made in order to close the $26 Billion “gap” will, however, have a tremendous affect upon Medi-Cal programs for persons not residing in nursing homes, upon child welfare programs, AIDS prevention, and low cost health insurance for low income children. Click on the link below for the full details. The cuts to Medi-Cal begin on page 15 of the Amendments:
Jinies.com