Month: May, 2012

welcome to girlfriends with aging parents

between a rock and …. well, you know

It is the time of year when we do honor to moms and dads (as well as grads). Lots of young people will be graduating and “moving on”. Yet, one of the challenges of our times is that many will be “moving back” instead of moving on. A recent PEW Foundation think tank, research report has dubbed the current generation of 25-34 year olds, the “boomerang generation”. The economic challenges that they face have caused a majority to find safety and comfort back home. The report was based on a survey that PEW conducted in December of 2011 of over 2,000 young adults across the USA. Thirty percent of that age cohort now live in what the study called “multi-generational” homes and, what may come as a surprise, “large majorities say they are satisfied with their living arrangements (78%) and upbeat about their future finances (77%).

At the same time, what also is happening is a growing concern about the economics of aging. A recent N.Y. Times article (May 6, 2012) on a type of dementia called frontotemporal dementia, again pointed out the growing challenge that it is going to cost our generation a lot of money to care for the rapid rise in chronic illness. And, we may not be able to count on our kids to help afford our own situations, as we have helped our parents. The lack of real debate in any level of government on the future of Social Security and Medicare only adds to the slowly growing reality that our boomer aging may very well be, in many ways, unaffordable. So, we need to ask them who will pay?

I raise this issue here only because it is so real and so many of us will be faced with these realities. We take for granted our health and mobility until that moment when we cannot…and then what?

The stresses and strains on families dealing with these issues are enormous. It appears that these will only continue to grow and I do not know if our generation is prepared. I would invite your comments on this issue.

Shalom,

Rabbi Richard F. Address, D.Min

www.jewishsacredaging.com

 

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clearing the paperwork cobwebs

Mom’s off to tennis, then lunch. Tomorrow, it’s dinner out before the theatre. Then there’s the monthly lecture series, which helps keep her connected and engaged. It’s no wonder her bills and papers and mail pile up. Do you worry the power company has her on the “pending disconnect” list?

Or Dad is becoming forgetful, and he’s agitated about all the paperwork he can’t seem to get organized. You’ve offered to help with paying bills and balancing the checkbook, but he’s still pretty independent and will have none of that. And with tax time here, his frustration has become more pronounced.

This scenario is familiar to many of us. And yet, as much as we want to help our parents (especially those of us at a distance, right?) the tasks of bookkeeper, bill payer and paper handler are getting in the way of our role as daughter and friend. And of course you don’t really want to spend your time with your parents searching for that one last receipt for the tax return.

A Daily Money Manager might be the answer. Daily money managers provide personal business assistance. The scope of their work can include bill paying, organizing tax documents and other paperwork, or processing medical insurance claims. A money manager doesn’t take the place of investment, tax or legal professionals. As a result, their fees are much lower, typically ranging from $25 to $100 per hour. In a couple of hours, every other week, a money manager could clear out all the clutter and keep everything organized.

In my experience, clients are more likely to accept assistance if they understand how much it will be a help to their children. As I’ve written before, besides the (sometimes irrational) fear of running out of money, elders are also very worried about being a burden to their children. The involvement of an outsider in personal financial affairs may be intimidating for some parents initially, but I know elders who now can’t imagine going back to the drudgery of paying bills and filing paperwork. A professional money manager will be sure to document a client’s decision-making capacity, and will work with you and your parents to determine what steps to take when that capacity begins to decline.

A personal business manager will take every precaution with confidential information, making your parents less likely to be victimized by identity theft. Such a professional can also be the first line of defense against excessive spending on useless items, “recreational shopping”, or unusually large or recurring donations to charitable or other organizations.

The American Association of Daily Money Managers can help you find and screen service providers. Your CPA or investment manager can also be a great resource for referrals. Submitted by Susan Talton

Susan M. Talton is a client advisor with Laird Norton Tyee in Seattle. With more than 25 years of wealth management experience, she enjoys nurturing close relationships with her clients to help them through significant life transitions.

 

 

 

 

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medicaid cuts impact senior access to pharmacy care

Providing quality health care for our beloved family members as they age is one of the most important aspects of being a caregiver. When we think of health care providers, we often immediately think of doctors, nurses, or physical therapists. But one of the most often overlooked providers is one many seniors see more often than any other: their community pharmacist.

Indeed, the pharmacist plays a vital role in the ongoing health of our loved ones in their golden years. They offer advice and instruction on the sometimes multiple and varied medications that seniors become accustomed to taking more of as time passes. Not only that, in many states pharmacists provide life-saving vaccines to senior citizens for diseases like shingles and pneumonia.

At Pharmacy Choice and Access Now (PCAN), we are fighting to ensure that pharmacy access remains available to everyone, including those who are most vulnerable, like our beloved parents, grandparents, and other senior family members. Seniors are among the population most at risk by the lost access to pharmacy care that is resulting from Medicaid reforms being made in several states.

As states across the country are slashing Medicaid reimbursements and taking other measures to cut costs, seniors are the collateral damage. Pharmacies in Texas started closing the next day after the state transitioned its Medicaid patients to managed care. Many rural areas only have one pharmacy to begin with, how will seniors access their medication if their only community pharmacy is forced to shut down?

In California, proposed 10 percent cuts to the state’s Medicaid program (Medi-Cal) threaten more than pharmacies. Senior health centers and care facilities will also feel the effects.

You can help us spread the word by visiting http://rxchoiceandaccess.com — by lending our voices, we may be able to help stop some of these disastrous reforms before they have the chance to hurt America’s seniors!

submitted by Pharmacy Choice & Access Now

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baby boomers effect on nursing homes

Projections: U.S. & Nursing Home Populations

Actual Projections

2010

2020

2030

Total U.S. Population*

308,746,000

341,387,000

373,504,000

Rate of change

10.57%

9.41%

65 and Older Population**

40,267,000

54,804,000

72,092,000

Rate of change

36.10%

31.55%

Nursing Home Resident Population***

1,401,718

Residents 65 and older****

1,205,477

1,640,673

2,158,226

* U.S. 2010 Census
** U.S. Census 2008 “Projections and Distribution of the Total Population by Age for the United States:
2010 to 2050″
*** CDC “Health, United States, 2010, table 117″
**** npg.org estimates that 86 percent of nursing home residents are senior citizens; Projections for “Residents 65 and Older” were calculated by applying 2010′s Actual “Nursing Home Resident Population” to that estimate.  That finding was then applied to both 2020 and 2030′s “Residents 65 and Older Rate of Change” to estimate both years Baby Boomer nursing home occupancy.

 

The nursing home industry is one plagued with a very big problem: 90 percent of nursing homes are understaffed, making staff to patient ratios too low according to the Centers for Disease Control’s (CDC) National Nursing Home Survey: 2004 Overview. Said report found there was only: 1 Registered Nurse for every 12.6 residents; 1 Practical Nurse for every 8.15 residents; 1 Nursing Assistant for every 2.5 residents; and 1 Nursing Aide/Orderly for every 120 residents. What this translates to is 1 nursing home staff member for every 1.64 residents.

As a result of inadequate staffing levels, the amount of time staff members spend with residents is also inadequate. A Health and Human Services (HHS) study in 2002 found that nursing homes could maximize quality of care if specific staff members met the following daily requirements of time spent with residents: Certified Nursing Assistants spent between 2.4 hours and 2.8 hours daily; Registered Nurses & Licensed Practical Nurses spent between 1.15 hours and 1.4 hours daily; and Registered Nurses spent .55 hours to .75 hours daily with each resident. However, the study found that given the current state of nursing home staffs, if said requirements were applied, only 3 percent of nursing homes would meet the maximum requirements and only 9 percent would meet the minimum requirements.

All of this data was representative of the nursing home population before Baby Boomers began to become senior citizens. Baby boomers began to be classified as such in 2011 and will continue to enter that age category through 2029. Future senior citizen populations applied to nursing homes can be seen in the above chart. Easily seen is this chart is that the senior citizen population increases in 2020, mid-Baby Boomer subversion, and in 2030, one year after full Baby Boomer subversion. And given that understaffing is a primary cause of both abuse and neglect in nursing homes, the increased demand Baby Boomers will put on a disordered industry may cause an increase in nursing home abuse and neglect. Additionally, elder abuse and neglect in general may increase, as people who would normally have placed their elder into a nursing home will be left with no choice but to care for the elder themselves.

Allison Dean is a writer bringing to us how the problems of nursing home abuse and neglect could be exacerbated by the Baby Boomer population’s demand for long-term care.

Allison also writes about

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when surgery may not be the right choice

My mother, 87yo, lives across the country but close to my younger sister. I was called to D.C. suddenly to have a “family meeting” about a new development regarding our mother’s health.

My sister reported that my mom had exhibited uncharacteristic behavior. Besides shortness of breath, Mom tended to stop as she was walking along to “window shop and look around”. Not typical behavior. I asked why she did that? Heart beating quickly, can’t get her breath? She could not pinpoint why she stopped. My sister & I thought … just the aging process.

Unfortunately this seemed to be more frequent & we decided to see a heart specialist. Through a stethoscope exam, the physician diagnosed a huge heart murmur. He further stated that Mom’s life was threatened by this condition. The cardiologist recommended we scheduled an angiogram to see what it looked like inside.

After confirming on the angiogram and making an appointment with the surgeon to choose open heart or to try to get a procedure through a leg artery (that is still only available to her as a randomized trial) a close family friend, who is a physician, scheduled a second opinion.

The second physician confirmed that everything we heard was completely true. This cardiologist however, pointed out that Mom has a great lifestyle, & in her late 80’s, would not be offered this procedure in a European country because of her age. He said that since she is not symptomatic yet (but will be without any doubt) the third option was to do nothing at this time. The doctor said it is very likely that she would not come out of the surgery the same cheerful optimistic person that she is today.

Conclusion? There is no real conclusion in health care until the actual end. Ours is a wait and see. You never know what you will eventually do. But we chose lifestyle over surgery. Also, it is a huge decision (and the decision, in the end, is the patient’s) Truly, it was good to have both sisters there as well as my Mother’s sister for support in that.

Maybe you have a reason for a second opinion you would like to share. Written by Linda in Scottsdale

 

 

 

 

 

 

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