The first and perhaps one of the emotionally taxing steps in the eldercare journey is actually figuring out how to begin. It most certainly isn’t the easiest conversation to bring up. To make a comparison, it can be related to a family intervention. However, this conversation sets the groundwork to enable an easier transition when the time comes to assist in your loved one’s desired plan of care. Planning ahead ensures that issues are addressed BEFORE the time comes to become more actively involved, when emotions are driving the decisions that you make. This is the difference between being proactive and reactive. Emotionally driven decisions often miss vital nuances.

What can you do to prepare?

In the Eldercare Ready Book I discusses dealing with this complicated issue based on my own experiences. Ultimately, it is a path of action that needs to consider everyone involved based on the multi-faceted dynamics that exist in every family. I believe eldercare is a journey. As with every journey, prior planning is required for a smooth trip. In planning for the future it is essential that you have the information and tools necessary to alleviate as much stress as possible to enable a continued focus on the comfort and care of your loved ones. In the ElderCare Ready Book, I have outlined these issues in a comprehensive, step by step fashion that illuminates issues that may be overlooked if you are in a reactionary position. These steps include but are certainly not limited to:

· Management of Finances
· Purchasing of desired groceries and health and comfort items
· Laundry
· Home and lawn maintenance
· Appointments
· Managing medication and procurement thereof
· Tax returns and preparation
· Asset management
· Coordination of activities

Communicating these issues begins the foundation of eldercare and assists in enhancing trust between the caregiver and the ones being cared for. For many, it can be difficult to relinquish independence and place complete trust in another person, even a family member, to handle the most personal aspects of their daily life and assets they have worked their entire life to acquire. Addressing the issue before a crisis situation happens can make the transition smoother for all involved, and make the eventual journey that much more manageable.

An experienced accountant recently advised me to have all my clients file a federal and state income tax return whether or not the client’s income was high enough to require it.  With the increase in identity theft and cybercrime, if a social security number is unlawfully obtained and used to file tax returns seeking a refund, the senior may never know that it is being done!  The IRS estimates that it sent out nearly three million fraudulent refunds out to con artists in 2013, which cost taxpayers $5.2 billion that year alone.  The Treasury Department predicts that by 2016, that number will be over $21 billion per year.  These con artists are nearly impossible to catch, since many of the IRS refunds are paid out to prepaid debit cards that do not need to be registered.  It is the senior whose social security number was stolen that will have to pay back all of the improper refunds made to the thief.

Seniors are often the hardest hit because many do not file returns each year because their income is below the mandatory filing limit.  This means that years can go by, with a scammer filing false returns on their social security number, before the identity theft is discovered.

If a return is filed, the maximum exposure would be one year as the IRS will reject the senior’s 1040 return if someone else had previously filed a return under that same social security number.  The senior, and the family, is thereby alerted to a theft issue and it can be addressed.  Heirs may have a big surprise from the IRS if the theft is not caught and many years go by with the thief filing the false returns and pocketing huge sums of money.  They will take off and leave the senior with the bill!

By catching an identity theft in the first year, the exposure is limited and may be minimal.  Filing as early as possible is therefore also suggested to stop any thief from filing a fraudulent return as his filing will be rejected due to a previous legitimate filing.  The good news is that the IRS is catching more fraudulent returns each year, but the numbers that get through are still staggering.  The IRS still does not have a truly effective way to stop tax return fraud, so filing returns each year may be the best way to protect yourself from getting stuck with a bill when someone else cashes out on your social security number.

It goes without saying that eldercare brings a host of new and confusing terms for families who are just starting out to navigate the waters of caring for an elderly loved one.  To make matters more complicated, different terms are used in different regions of the US, and even in the same area, many professionals use differing terms to describe the same type of care.

One of the most confusing aspects for families is the question of a nursing home vs. assisted/independent living.  The subject becomes even more complicated when you consider the fact that for years, the term “nursing home” was used as a blanket term to describe several types of old age homes.  Many people still associate that term with all levels of care, including assisted or independent living.  Just think back to the Golden Girls, when Sophia (played by the late Estelle Getty) feared returning to the dreadful “Shady Pines” nursing home.  In fact, Shady Pines was much more like an assisted living facility, rather than a nursing home.  Fear not Sophia, our blog post today will help to clear up those terms a bit.

Here is a general rundown of what each type of facility provides, as well as a helpful infographic from AssistedLivingFacilities.org and SkilledNursingFacilities.org.

“Assisted Living” is a blanket term often used to describe a range of different facilities that usually provide a communal living environment where residents can live in a setting that provides basic assistance and a safe environment for those who are starting to need help with daily tasks.  Assisted living facilities usually offer meal preparation, cleaning, activities, and other basic services.  The term assisted living is also often used to cover the sub-categories of independent living or memory care.  Independent living facilities offer similar services, but with a more hands-off approach, designed for residents who are still largely independent and self-sufficient.  Conversely, memory care is designed for persons who need a more supportive environment due to diseases that cause cognitive impairment, such as dementia or Alzheimer ’s disease.  All in all, assisted living is designed to provide support while maintaining a more homelike atmosphere for its residents.

“Nursing Homes” or “Skilled Nursing Facilities” are designed for people who need a higher level of medical care and support.  These facilities often resemble hospitals, with nurses and medical staff present at all times.  Residents in nursing homes are usually mostly or completely unable to care for themselves without substantial assistance.  Nursing homes generally have a much higher cost per month when compared with assisted living facilities, but unlike assisted living (in most cases), government assistance is usually available to help pay for a nursing home stay.  However, these government programs are usually dependent on a person’s ability to pay and their financial resources.  Nursing homes can provide general medical care to treat a variety of disabilities, or they can provide acute care to treat serious illnesses that require a higher level of medical attention.

See the infographic below to learn more about the differences between these two types of care.

I found it quite enlightening when I used my mom’s walker and traveled around her apartment. It gave me a better perspective on how she needs to maneuver and where the fall risks are.

Power cords are like trip wires from Vietnam!  Get them out of the way immediately.  Make sure that the chairs are accessible from the walker.  Are the chairs stable or do they have wheels that could cause a problem?  Are there other fall risks?

Be like a detective on a TV crime show.  Walk the scene and you will be surprised what you discover!  You will be surprised to find that there could be many more trip hazards than you could ever have imagined.  A fall can put a senior out of commission for a long time, due to their increased recovery time needs.

Have any of you discovered hidden fall risks?

Getting ready for eldercare is like going on an extended trip.  You pack your suitcase with the necessary items, such as toiletries, clothes, jackets and the like.  You may also pack a bathing suit just in case you might want to take a swim.  You might pack your tennis outfit just in case you get a match along the way.  Once you are packed and you leave for your trip, all your experiences occur in the moment.  You can’t pack for that chance meeting on the beach or that dinner that exceeded your expectations.

Eldercare preparation is very similar.  You need to pack for the trip so that you are prepared for the experiences in the moment.  So, when your mother goes to the hospital at 2AM, you have her medication list, her doctor list, her health care documents all readily at hand, for example.  Eldercare events tend to almost be surprises, at inconvenient moments, or in difficult situations.  Most people find themselves so unprepared to face unexpected events like a parent’s sudden illness, injury, or financial issue.  These events also tend to cascade, compounding the problems that might all seem to occur at once.

If you can prepare ahead of time for these events and compile some of the most helpful information and documents, you will be able to decrease your stress and strain exponentially.  In the coming weeks on this blog, I will be sharing some more helpful tips and info to help you prepare for eldercare, before the inevitable incidents happen.  It’s never fun to go on a trip without packing well!

As a senior’s health begins to fail, there comes a time when a conflict arises between the parent’s interests and the children’s interests when it comes to safety and autonomy. There were polls done among parents and their children and the overwhelming results are that the parent wants to keep their autonomy and the kids what to guarantee the parent’s safety. How are these at odds?

The problem is that you can’t have both. To a large extent they can be mutually exclusive interests. So who should prevail? Even if the parent may not have competency to make financial decisions or make health care decisions for themselves, they are still able to clearly communicate their wants and desires. They still are emotional beings and I believe that the parent’s mental health needs to be an important factor in determining the safety requirements and concessions that are thrust upon the parent.

Even though it may be difficult for children to accept, shouldn’t there be a balance between maintaining as much of the parent’s autonomy and still keeping the parent safe? Perhaps let them fail in caring for themselves just don’t let them get hit by a bus! Sometimes a parent or elderly person is much more accepting of the fact that they need to let go of a bit of their autonomy if they are able to come to the decision on their own, rather than having a third party force the issue.

What are the thoughts of my readers? At what point must the children step in and demand freedom be taken away from the parent to assure their safety? I want to invite you to tell me what you think, and to share your experiences from your own family or friends.

What exactly is ElderCare?

My definition of eldercare is not necessarily helping your folks with bathing, grooming, toileting, and the like (which many families do), but rather all the other stuff like making doctor appointments and taking them to the doctors; handling all their financial business of deposits, bill paying, tax return preparation; handling phone calls, visits, and taking them out for entertainment; grocery store trips; and much more.

The amount of time spent in a given month can be staggering and it is just not spent all at one time. Does this affect your work? Yes. Does this affect your personal time with family and friends? Absolutely. Not that we resent helping them but it is definitely like a second job and it does have a long term effect on one’s mental and physical health.

By the way the senior citizens have a LOT of doctor appointments!

Over time I have came across a few helpful tips and bits of information that have made my helping to manage my family’s life easier.  Check back soon for new posts!