Invisible Heroes

They live in your city, perhaps on your street or even next door.

They serve with courage, perseverance, patience and love. Some give 24 hours a day, with days blending into weeks, months and years.

They are family caregivers; heroes quietly caring for loved ones at home.

There are over 66 million family caregivers in the United States, taking care of someone with Alzheimer’s or dementia or who have physical inabilities. The overwhelming responsibility can be very difficult and emotionally wearing on the caregiver. Without some type of support the caregiver may end up with his or her own health failing. Stress, guilt, anger, depression and withdrawal from family and friends are some of the emotional feelings that leave these people feeling helpless. Many caregivers give up employment to attend to their loved ones’ needs, causing financial stress as well.

National Family Caregivers Month was established in November to draw support for caregivers across the nation. In addition, November is National Alzheimer’s Disease Awareness Month. In the United States alone, there are nearly 15 million Alzheimer’s and dementia caregivers.

Emphasis from support organizations is put on helping caregivers by educating them on resources available to them to help provide care to their loved ones and in the process take care of themselves. Government and private companies have added many programs that help caregivers. By providing education, services, health counseling and respite care for caregivers they are making available the helping hand that is very much needed.

The Area on Aging Caregiver National Caregiver Support Program extends throughout each state to provide local services.

“The National Family Caregiver Support Program (NFCSP), established in 2000, provides grants to States and Territories, based on their share of the population aged 70 and over, to fund a range of supports that assist family and informal caregivers to care for their loved ones at home for as long as possible.”

Medicare’s website offers education and resources for caregivers offered through Medicare.

“Medicare toolkit offers informational resources that can be printed directly from this Web site and provided to caregivers. The resources are designed to help caregivers address challenging issues and work effectively with Medicare to ensure their family members and friends receive the best possible care.”

Whether it is senior centers, local church groups or community groups that reach out with hands-on support; volunteers are found in every community. Private care providers can also help caregivers with the day-to-day responsibilities, enabling them to have time to spend on their own needs. There are large numbers of Home Care companies across the nation that provide medical and non-medical care as needed by the family caregiver.

Whether it is senior centers, local church groups or community groups that reach out with hands-on support; volunteers are found in every community. Private care providers can also help caregivers with the day-to-day responsibilities, enabling them to have time to spend on their own needs. There are large numbers of Home Care companies across the nation that provide medical and non-medical care as needed by the family caregiver.

The National Care Planning Council provides a website of resources for caregivers.

“National Care Planning Council and our web site “longtermcarelink.net”, the most comprehensive resource for Eldercare (Senior Care) and Long Term Care Planning anywhere.”

Computer Use Combined With Exercise May Protect Memory

Mayo Clinic researchers think the two may work together to boost mental fitness in old age.By Ankita Rao | Posted Friday, May 4, 2012, at 2:59 PM ET

Researchers singled out computer use as an activity that protects against age-related memory loss

Photo by Laurent Fievet/AFP/GettyImages

Time magazine flags some interesting health news for those of us who spend our days in front of a computer screen: A new studysuggests that using a computer may help stave off memory loss in old age.

The catch? When you’re not at your desk, you need to be doing some moderate exercise, like hiking or tennis.

That was the conclusion of Mayo Clinic researchers who took a look at the relative cognitive health of subjects between the ages of 70 and 93. The study suggests that those who reported using a computer and frequently engaging in moderate exercise were significantly less likely to experience age-related memory loss than those who only did one or the other or neither.

While the researchers have not identified why the computer-exercise combo yields those results, they speculate that the healthy effects of exercise coupled with the neurological stimulation of using a computer most likely work together to boost mental fitness.

“The mental stimulation may be polishing the communication lines and giving good connections between neurons,” lead researcher Dr. Yonas Geda told the magazine. “It’s like working in a concert. When the two processes come together, it works like a symphony.”

Is Insurance the Answer to Long Term Care Planning?

A recent USA Today article states that there is an increase in seniors living over the age of 90.  According to author Haya El Nasser “The number of people living to age 90 and beyond has tripled in the past three decades to almost 2 million and is likely to quadruple by 2050”.

Seniors who live longer generally have some sort of disability or need help at some level of living. Sandy Markwood, CEO of the National Association of Area Agencies on Aging, indicates that the focus needs to be on being able to help these seniors live at home as long as possible as nursing home cost could rise to average $72,000 a year.

Long Term Care at any level, in the home, assisted living or nursing home can add a tremendous cost to seniors and their families.

Government Programs Only Pay For About 16% Of Long Term Care

Government programs such as Medicare, Medicaid and the Veterans Administration will cover the cost of long-term care under certain conditions. Medicare will cover rehabilitation from a hospital stay or limited care at home if there is a skilled (medical) need. The Veterans Administration will cover the cost of nursing home care indefinitely if the veteran is at least 70% service-connected disabled. The VA will also cover other forms of home-based or community-based care if there is a medical need.

Medicaid will cover both medical and non-medical related long-term care but in order to qualify for Medicaid a person has to have less than $2,000 in assets and income that is insufficient to pay the cost of care.

Funding Long Term Care with your Life Insurance Policy

Drawing cash from life insurance or changing a life insurance policy should only be done after reviewing with an expert advisor.  Loss of the policy and death benefit could prove to be a detriment.  If, however you have accumulated cash in a life insurance policy and no longer need the coverage you may consider using the cash for long term care or purchasing a LTC rider to your current policy.

New insurance products are being developed to cover both life insurance and long term care insurance. ElderLawAnswers reports:

“A new law makes the purchase of products that combine annuities or insurance policies with long-term care insurance more attractive. These “hybrid” products are gaining in popularity due to a law that went into effect January 1, 2010, making distributions from life insurance and annuities tax-free when used to pay for long-term care. The same law also allows owners of annuities or life insurance policies to exchange their old policies for long-term care insurance or hybrid policies without being taxed.”

Combination sales which include life insurance, annuities and traditional long-term care coverage are becoming popular with insurance companies and may prove a method of financing long term care.  Investigate closely, however to find what exactly will be covered.  Some policies do not cover home care costs or complete costs of nursing homes.

Long Term Care Insurance Funding for All Long Term Care Needs

The first long-term care policies were offered about 40 years ago. These were primarily nursing home-only policies designed to take over when Medicare rehabilitation ran out. They were not the comprehensive benefit policies we see today.

Long Term Care Insurance policies today are greatly diversified in their coverage.  Home care, nursing home costs, adult day care, physical therapy, skilled and non-skilled nursing care are some of the services covered.  Policies vary in price and what they cover.  There is also a very restricted qualification of physical and mental heath to get a policy.  Purchasing a policy at a younger age makes it easier to qualify and also provides cheaper premiums. It is best to consult with a long term care insurance professional about the type of policy that fits your needs and budget.

Veterans Aid and Attendance Pension Benefit

Though not an insurance policy, the VA Pension Benefit should be mentioned as a way to pay for long term care needs.  A veteran or spouse of a veteran who served during a period of war can receive money, up to $2,019 a month, to pay for long term care medical expenses, home health care, and assisted living cost.  A qualified Veteran Consultant can help you determine if you qualify for this benefit.

Pre-Need Burial Insurance

One might ask what Pre-need burial insurance has to do with long term care. The purpose of preneed life insurance is to set aside funds for your funeral, before the need arises.
It is an insurance policy that covers the cost of the predetermined expenses of a funeral, cremation or burial.  It gives the purchaser the opportunity to preplan the services and peace of mind in having it paid for.  This is usually an insurance policy that pays at time of death for these expenses. There are many insurance companies that offer these packages as well as funeral homes.

The saddest cases of long term care needs we hear are:

“Mother can no longer live alone and she has no money to go live in a care facility.”

“ Is there someone that can come help me take care of my wife?  We live on our Social Security and I can not pay what home care costs.”

“Father died last night and we have no money to bury him, what do we do?”

It is important to make the necessary arrangements to cover long term care and end of life costs.  There is no government program that will cover all those needs. The National Care Planning Council at http://www.longtermcarelink.net strives to educate people about long term care services and encourages the planning that needs to be done to prepare for future costs and needs.

Recognizing the Need for outside Help in Caregiving

Caregivers often don’t recognize when they are in over their heads, and often get to a breaking point. After a prolonged period of time, caregiving can become too difficult to endure any longer. Short-term the caregiver can handle it. Long-term, help is needed. Outside help at this point is needed.

A typical pattern with an overloaded caregiver may unfold as follows:

1 to 18 months – the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.
20 to 36 months – the caregiver may be taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.
38 to 50 months – Besides needing tranquilizers or antidepressants, the caregiver’s physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help.

It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled loved one in a facility. Without intervention, the caregiver may become a candidate for long term care as well.

With the holiday season upon us, caregivers feel even more stress — with planning, shopping and participating in holiday activities. This is a perfect time for family and friends to step up and provide some respite time and caregiving help. Whether it is provided personally or arranged as a gift of services to be provided by a professional respite company or home care provider, it is a welcome gift.

An article in “Today’s Caregiver” states:

“Nearly one in four caregivers of people with Alzheimer’s disease and other dementias provide 40 hours a week or more of care. Seventy-one percent sustain this commitment for more than a year, and 32 percent do so for five years or more. One of the best gifts you can give someone caring for Alzheimer’s is something that relieves the stress or provides a bit of respite for the caregiver.
The Gift of time: Cost-effective and truly meaningful gifts are self-made coupons for cleaning the house, preparing a meal, moving lawn/shoveling driveway, respite times that allow the caregiver time off to focus on what he/she needs.”

It is also important to note that hiring professional care provider services can provide valuable ongoing support to an overloaded caregiver. A financial planner, care funding specialist or a reverse mortgage specialist may find the funds to pay for professional help to keep a loved one at home. A care manager can guide the family and the caregiver through the maze of long term care issues. The care manager has been there many times — the family is experiencing it for the first time.

An elder law attorney can help iron out legal problems. And an elder mediator can help solve disputes between family members. There are also cash benefits for Veterans, who served during a period of war, that pay for home care or assisted living.

If you are the one providing daily care for a loved one, you owe it to yourself to seek help.
Take care of yourself and your needsm, both physically and mentally. Seek out professional help that will ease your burden and look for community service organizations that offer respite help.

The National Care Planning Council’s website http://www.longtermcarelink.net contains hundreds of articles with tips and advice for caregivers and their families. Take a few minutes to find the help you need and enjoy this holiday season.

CELEBRATING FAMILY CAREGIVERS – NATIONAL CAREGIVERS MONTH

Debbie turned the ringing alarm off. It was 6:00AM and time to get herself ready for the day. Her son would be there soon to help her shower and dress her husband Jim. Her son came every day before work to help because Debbie, at 75 years old and suffering with arthritis, could not lift Jim out of bed or help him to the shower. This has been the daily routine since Jim’s stroke a year ago. When her son leaves for work, Debbie spends the day caring for Jim’s needs.

President Barack Obama, in his Presidential Proclamation of National Family Caregivers Month -2011 states:

“Across our country, millions of family members, neighbors, and friends provide care and support for their loved ones during times of need. With profound compassion and selflessness, these caregivers sustain American men, women, and children at their most vulnerable moments, and through their devoted acts, they exemplify the best of the American spirit.”

Statistics from the Administration On Aging show that the population 65 and older is expected to grow from its current 13% to 19% of the total population by 2030. With the older population increasing, the need for elder caregiving will continue to increase. Family caregivers play a vital role in filling these caregiving needs. Who better than family can understand the needs and ensure the best care of their loved ones.

Caregiving can be very stressful and demanding. In the case of a healthy spouse or a child living with the disabled person at home, caregiving can be a 24 hour, 7 day a week commitment. But even for the caregiver not living in the home, looking after a loved one or friend can consume all of the caregiver’s free time.

Surveys and studies consistently show that depression is a major problem with full-time informal caregivers. This is typically brought on by stress and fatigue as well as social isolation from family and friends. If allowed to go on too long, the caregiver can sometimes break down and may end up needing long term care as well.

A typical pattern may unfold as follows:

1 to 18 months–the caregiver is confident, has everything under control and is coping well. Other friends and family are lending support.

20 to 36 months–the caregiver is taking medication to sleep and control mood swings. Outside help dwindles away and except for trips to the store or doctor, the caregiver has severed most social contacts. The caregiver feels alone and helpless.

38 to 50 months–Besides needing tranquilizers or antidepressants, the caregiver’s physical health is beginning to deteriorate. Lack of focus and sheer fatigue cloud judgment and the caregiver is often unable to make rational decisions or ask for help. It is often at this stage that family or friends intercede and find other solutions for care. This may include respite care, hiring home health aides or putting the disabled care recipient in a facility. Without intervention, the family caregiver may become a candidate for long term care as well.

Since most family members go into informal caregiving without training or counseling, they often aren’t aware of the possible outcome described above. It is therefore extremely important to seek counseling and to formulate a plan of action prior to making a caregiving commitment.

According to the National Care Planning Council:

” In 1965, Congress passed the Older Americans Act which provides guidance and funding to the States to give help to caregivers. All states offer programs at no cost or very low cost which might include: counseling, caregiver training, respite care, adult day care, meals, support groups and much, much more. It is vital for the health and longevity of all caregivers to make use of these services.” (www.longtermcarelink.net)

In 1994 President Clinton proclaimed a week in November as National Family Caregivers week to be observed with appropriate programs and activities. It has since been changed to the whole month of November with each President giving a yearly proclamation for its observance.

Government assistance is available all over the country. Area Agencies on Aging and local senior centers give aid and support to family caregivers. Numerous religious and community organizations also lend their support.

This month of November 2011, as individuals, we can take note of those around us, in our families and community, who are family caregivers. A note of acknowledgement of their service, a gift of thanks or even an offering of our time to give them a needed break would let them know their service is recognized and appreciated.

Living With Alzheimer’s Disease – From the Inside Out

http://myemail.constantcontact.com/Richard-s-Latest-Newsletter–Alzheimer-s-From-the-Inside-Out-.html?soid=1101525128114&aid=79OuKxPZTmY.

Richard has Alzheimer’s – read what it is like for him.  I’ve copied it below also.

I’m home again!  I am Richard and I live with and have been diagnosed with the symptoms of Dementia, for sure, probably of the Alzheimer’s type. Spending a week in Spain at a conference sponsored by the Queen – and then a week on the French Riviera, and then a week in Iowa at the School of Nursing at the University of Iowa has depleted my energy reserves, my cognitive reserves, and my weight reserves (lost 10 pounds!). 

However, recall of the specifics of the business and play are as usual difficult to retrieve, and when I do, I have little confidence they are what really happened. Linda and I spent a week living with Cathy and John with their view of the port of Nice, France from their bedroom floor to ceiling windows

I wish I could say all this travel has refilled my energy tank, but it has not. It was wonderful being around friends, rubbing shoulders with the movers and shakers of the Alzheimer’s world.

Many walk their talk, while others walk/act in a twisted way at best and an opposite way at worst away from their talk.

No one, nowhere seems anywhere near to being fully prepared for the public health crisis. Some are closer, while many are not. There are many dementia angels speaking up and out, but they have yet to be drawn into a choir that sings loud enough for everyone to hear. The movement, if indeed that is what it should become, lacks leadership, funding, sufficient staff, a shared and burning sense of connectedness, an umbrella organization, and the urgency at least as I feel it, to stand up and speak out. As for myself I am trying to feel comfortable speaking/expecting one person at a time to consider my experiences, my messages, and then decide for themselves if what they think and feel about themselves and others dealing with dementia are correct, incorrect, confused, don’t care, don’t know, know/but don’t care. and/or don’t want to know. Must you be living with the symptoms of dementia to feel the necessity for large-scale change NOW?

I lack the ability to understand why this is all happening in the face of the urgency for myself, millions of others, and millions and millions of others who are or will live with the disability of dementia within the next ten or twenty years. Why do so relatively many spend so relatively much on cure research, sacrificing psychosocial research to pharmacological research? Why do so many seem so hopeful for tomorrow, when there is so much more they could do today?

 I do not know. If you do, please drop me a line and maybe we can change the world, or at least greatly improve the quality of the lives of souls living with dementia, all of whom are also living with the stigmas of the long good bye, dying twice, losing our souls, becoming sufferers.

Richard 

 

Can I Get Paid to Care for a Senior Family Member?

As the number of family members providing care for aging parents increases, the solutions to find help with loss of income because of time off from employment for caregiving has become a major concern for many.

The demands on both the time and energy needed to provide the needed care can make it impossible to maintain both a full time job with full time caregiving.

Seeing a need to give support to family caregivers the federal government Administration on Aging created the National Family Caregiver Support Program.

State Area on Aging division manages this program on the state and community level to offer support services that include:

Information to caregivers about available services;
Assistance to caregivers in gaining access to supportive services;
Individual counseling, organization of support groups, and caregiver training to assist caregivers in making decisions and solving problems relating to their roles;
Respite care to enable caregivers to be temporarily relieved from their care giving responsibilities; and
Supplemental services, on a limited basis, to complement the care provided by caregivers.

Medicaid Cash & Counseling Program

A Medicaid approved assistance program called Cash & Counseling may be used to provide funds to hire personal care aides as well as purchase items or services, including home modifications that help them live independently.

The PayingForSeniorCare.com website gives the following information about the program:

“For Medicaid eligible seniors, the process begins with an assessment in the home to determine the senior’s home care needs; this includes interviews with caregivers and possibly the senior’s physicians. A determination of how many monthly care hours are required is made. The benefit amount is calculated using that determination and cost of care for that geographic area. This amount can be increased or decreased as the senior’s needs change. A family care giver may need to qualify as a home health aid by the state to receive these funds.”

This program is executed by each individual state Area on Aging Services division. It is a relatively new program and is not yet available in all States. Check with your state Area on Aging Services department for availability.

Using the Veterans Aid and Attendance Pension Benefit

A totally overlooked source of money to pay family caregivers to provide care at home is the Aid and Attendance Pension Benefit. This money is available to veterans who served during a period of war. Pension money is also available to the widows of these veterans. This benefit, under the right circumstances, can provide up to $1,949 a month in additional income to pay family members to provide care at home.

Getting the aid and attendance benefit to pay for family caregivers is not an easy task. This is because there must be a caregiver contract in place, a physician medical evaluation done, income and asset qualifications met and proof of medical expenses provided. Submitting the correct forms and documentation can easily be completed with the help of a VA Accredited Consultant who understands the process.

Long Term Care Insurance Benefit

If the senior being cared for has a long term care insurance policy that covers home care, payment to the care giver from this source could be arranged. Some policies require the care provider to be through a licensed home car agency, but others will pay for individual aides certified as such. This would require some training by the family member to become certified. There are policies that pay a daily benefit amount to the insured to use as they want to pay for their care. Check with a long term care insurance professional about types of policies.

Caregiver Contract

In some cases the senior parent has the funds to pay for care. If a family member is giving care it is very important that a caregiver contract be in place. A signed and dated agreement will outline the services provided as well as the amount of pay for these services. The contract will eliminate questions about what is expected from both parent and caregiver as well as providing a legitimate contract and payment record of services to qualify for Medicaid.

Attorney John L Roberts, in his article titled “Caregiver Contracts that Protect Elders and Their Family Members” states:

“A written Caregiver Contract is a good idea for every family that wants to protect family harmony, and make sure everyone in the family understands how care is being provided to an elder.

The family member who provides care can save an elder from needing nursing home services, and may also protect assets if nursing home care is needed in the future. Elders who want to cover all of these bases must have a written Caregiver Contract. Whenever adult children and other family members are providing valuable care, only a written agreement will protect assets from nursing home care costs and qualify the elder for Medicaid.”

In having the parent pay a family member for caregiving, it will be an employer/employee situation and payroll records must be kept with payroll taxes paid.

This can also be set up by an elder law attorney at the time the contract is done.

Final Note

Taking the time to create the caregiver contract, research the government and state services that are available to caregivers and using community resources will make the family caregiving experience less stressful.

“The 4 Steps of Long Term Care Planning” from the National Care Planning Council