Elderly Financial Abuse

It is estimated that over 80% of incidents affecting millions of seniors who are the victims of financial exploitation each year go unreported. Seventeen states and Washington, D.C. have passed laws that require bank personnel to report suspected cases of elder financial abuse and hold banks liable should they fail to report suspicions of elder financial abuse. Another 33 states recommend that bank personnel report those suspected cases.

~Serena Brock

HAPPY THANKSGIVING

Avenue Homecare would like to wish our family, friends, and clients a Happy Thanksgiving.

The Key to Alzheimer's: Recognizing Symptoms and Seeking Early Detection

In a new online survey conducted by Harris Interactive and commissioned by the Alzheimer's Disease Screening Discussion Group (ADSDG) titled, "Alzheimer's Disease: Current Attitudes, Perceptions and Knowledge," it is reported that nearly 95% of the survey participants agreed they would encourage a loved one to seek early diagnosis if they suspected signs of Alzheimer's disease (AD).

However, the report goes on to state that of the 34% who previously thought a loved one had the disease, only about one-quarter prompted that person to take an AD screener test, and less than 40% encouraged initiating a conversation with his or her doctor.

Given the rise of AD as the baby boomer population ages - up to 16 million are estimated to have the disease by 2050 - these new survey results are particularly important. The ADSDG encourages everyone with a loved one age 55 and over to visit http://www.seethesigns.com if symptoms are suspected. The link has resources to learn more about the disease, its signs and symptoms, and has an online memory screener one can complete on behalf of a loved one.

~Serena Brock

What is a Do-Not-Resuscitate order?

A do-not-resuscitate (DNR) order is an instruction, issued for a specific person, by a physician providing treatment for that person; the instruction advises that the person has indicated that he or she does not want cardiopulmonary resuscitation (CPR) in the event that his or her heart stops beating or he or she stops breathing. A DNR order in a person's clinical record instructs agency or facility staff, emergency medical services personnel (including ambulance personnel), hospital staff and physicians not to initiate CPR.

~Serena Brock

WHAT IS A HEALTH CARE PROXY?

A health care proxy is a document created by a person (the principal) that names another person as his or her health care agent to have the authority to make decisions if and when the principal is determined to be incapable of making medical care decisions for himself or herself.

~Serena Brock

Being a Health Care Agent for a loved one

Advocating for your loved one can be a difficult task. You should ensure that you are comfortable taking on this responsibility and have ongoing conversations with your loved ones about their wishes for end-of-life care. One of your most important responsibilities will be to communicate with your loved ones healthcare providers to ensure your loved ones wishes are honored.

How to talk with a doctor if you are a healthcare agent:
Establish open communication with the doctor.
Make an appointment to speak about your loved one's care.
Be assertive in expressing your wishes. Clearly state the reasons behind your requests without being hostile.

Ask questions. To be effective and to make informed decisions, learn as much as possible about your loved one's condition and prognosis.

Ask about the goals of the treatment plan - often. A physician's definition of recovery can be different from what is acceptable to you or your loved one. Seek the assistance of a social worker or patient representative if necessary. Such professionals can help improve communication between you and the physician.

Don't be afraid to speak to the facility's administration. If the physician is unresponsive, go directly to his or her superiors, including the chief of medicine, risk manager, hospital lawyer or administrator.

~Serena Brock

Family tug of war - how to make sure it doesn't pull you - or your finances - apart

You're rushing to drop the kids at school, fumbling with coats and lunch boxes, when you get the call. Dad has fallen down the stairs, is in the ER and your mom is panicking. She needs you to come home, now.

You want to drop everything. Your heart is racing and you can barely hold back your tears, because "home" is 2,000 miles away, and the last-minute flight, plus the home health aide you'll have to hire, will set you back $1,500 at least. Not to mention that you have a huge presentation to your biggest client this afternoon. All of the sudden, your anxiety level has gone through the roof and you can’t figure out how you will get home, get your kids, not lose your biggest client and manage to pay for the last minute details as a result of the situation.

All I can say, is, welcome, boomer. You're not just part of the sandwich generation - you're part of a triple-decker club with all the trimmings.

And if you feel trapped in the middle, you've got company: According to the Pew Research Center reports, Nearly 10 million boomers are now raising kids or supporting an adult child while giving a financial hand to an aging parent.

We can all relate to this situation and only hope that we are prepared. So let’s consider our own retirement and our own family preparation and protection.

There are so many resources available today, from local programs to national organizations, from books to Web sites, a veritable cottage industry has sprung up to assist you in juggling the demands of raising kids while also caring for aging parents.

Some of these services are a direct response by the government to meet the needs of the country's burgeoning senior ranks - with you, the taxpayer, footing the bill.

Others are the work of smart entrepreneurs who spy a business opportunity. Still others come from fellow boomers wanting to share what they've learned as they've grappled with these issues.

It is important that you consider your choices carefully. Although the situation may have come on suddenly and you feel overwhelmed and uncertain of how you will manage it all, take a deep breath, sit down and review your options.
1. If you have not had these conversations with your parents, now is the time. How are they doing financially and what plans have they made to protect them should be become ill or incapacitated?
2. How is your own personal financial situation? Now is a good time to make certain that your own family is protected, too.
3. Do you have POA? If an emergency situation arises, you will need to have the legal authority to act on your parents behalf. Talk to an attorney about a durable power of attorney, which will authorize you to sign checks, pay bills and make financial decisions on their behalf. You will need a durable power of attorney for health care (healthcare proxy), authorizing you or someone to make medical decisions and also ask about a living will, which will outline their wishes should their be a life-sustaining medical situation. An attorney will also further direct you and your parents with the appropriate planning options.
4. You need to know about your options should a nursing home stay come into the future. Bills for a nursing home, assisted living or in home care are very costly.
5. Before you do see an attorney, gather all of the policies that your parents may have as it relates to insurance. Do they have long term care insurance?
6. Talk to your parents about all of their issues, concerns, wishes. What do they want to happen? Faced with reality, where do they want to live? How do they wish to be cared for? Are there things that they wish to happen? What do they want to avoid?
7. Plan to protect them, and your own family. This is a great time to ensure that you do not leave your own children in a similar position. Planning in advance is the best option.

Serena Brock

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Aging with Dignity: Help is in place for our diverse, aging population

In June of 2007, Aging with Dignity, a non-profit organization launched a campaign to support our diverse aging population with the importance of end-of –life decisions, including using advance directives.

Five Wishes is a planning tool that helps individuals express how they want to be treated if they become seriously ill and unable to speak for themselves. It is an Advance Directive, or living will, that helps people make important end-of-life-care decisions that address their medical, personal, emotional and spiritual needs before a health crisis. Five Wishes helps answer the following questions:
Who will make decisions for you when you can’t make them yourself?
What kind of medical treatment do you/don’t you want?
How comfortable would you like to be?
How do you want people to treat you?
What do you want your loved ones to know?

Five Wishes meets the legal requirements in 40 states and is used as a model to prepare Advanced Care Directives in the remaining 10. It is now available in Albanian, Bengali, Arabic, Chinese (traditional and simplified), Croatian, French, Gujarati, Haitian Creole, Hindi, Hmong, Japanese, Korean, Polish, Portuguese, Russian, Somali, Spanish, Urdu and Vietnamese, in addition to English.

The 500,000 Wishes Campaign is a nationwide “call to action” from leading organizations that are committed to focusing attention on the importance of end-of-life-care decisions and communicating those decisions to caregivers and family members. Additionally, the campaign is a response to the increasing number of people who require assistance in communicating their wishes in languages other than English. It has received much support and endorsement from many people including U.S. Assistant Secretary for Aging, Josefina G. Carbonell, who joined the launch of the 500,000 Wishes Campaign.

For more information on this program, please visit www.agingwithdignity.org

~Serena Brock

Personal Emergency Readiness

The unfortunate disasters that we have all been witness to, victimized by or known someone involved in has made us more aware of how quickly our lives can change. In fact, these recent disasters remind us that personal emergency readiness needs to be a priority for everyone, including older adults and caregivers.

AoA recommends a simple, three-step approach:
Step 1: Know the basics . Learn about the risks your particular community faces; know how to do things like turning off your gas and electricity; get to know your neighbors.
Step 2: Have emergency supplies ready . This includes items you would need to survive in your home until help arrives; it should also include a personal evacuation bag, partially packed and ready to go.
Step 3: Make a personal plan. Many older persons have special needs relating to medications, medical equipment, mobility, and support services; making a personal emergency readiness plan increases the likelihood that essential needs will still be met, even in an emergency situation.

For more information about AoA 's Emergency Preparedness and Response efforts, visit the Administration on Aging website at www.AoA.gov

~Serena Brock

Sandwiched?

The Sandwich Generation is a generation of people who care for their aging parents while supporting their own children. Merriam-Webster officially added the term to its dictionary in July 2006.

For Example:
Thomas and Liz are a couple in their 40s. They are busy raising a family of three children. They also spend much time each week at their parents' homes doing yard maintenance and running errands for their parents. Thomas and Liz are members of the Sandwich Generation.

In the United States, Sandwich Generation Month is a month of awareness to commemorate and celebrate the dedication, patience and caring of adults who are part of the Sandwich Generation - those caring for their children as well as their own aging parents. Sandwich Generation is officially registered within the National Special Events Registry as an annual national observation, occurring each July 1-31. Events are held throughout the United States in annual commemoration of the national observation. Sandwich Generation Month brings the community and families together to heighten understanding of the special needs of the Sandwich Generation. It also spotlights community support available to those working hard to maintain multi-generational families.. According to the Pew Research Center, just over 1 of every 8 Americans aged 40 to 60 is both raising a child and caring for a parent, in addition to between 7 to 10 million adults caring for their aging parents from a long distance. US Census Bureau statistics indicate that the number of older Americans aged 65 or older will double by the year 2030, to over 70 million.

Source: Wikipedia.com

~Serena Brock

Important Medicaid Notice

The requirement for submission of a signed Letter of Attestation for Federal Fiscal Year 2007 has passed. Letters of Attestation have not been received from many provider types. This includes individual and group physicians, adult care homes, home health agencies, skilled nursing facilities, etc. Claims will begin denying early November 2008.

Please visit our False Claims Act web page for more information at http://www.ncdhhs.gov/dma/fca/falseclaimsact.html . There you may access a searchable database to see if a provider must attest this year.

For additional questions contact EDS Provider Services at 1-800-688-6696 or 919-851-8888 option 3

~Serena Brock

There are good agencies and not so good agencies!

This is a venting blog. I absolutely love my role in home care. In fact, I think that those of us who provide home care today are some of the most compassionate, caring individuals. Then, there are those who are clearly only in the business for business.

Tonight, I had the privilege of meeting one of the sweetest ladies I have ever met. Her son, now 5, still requires 24/7 nursing care and will for the rest of his life. I can handle that part, as sad as it is, some of these moms that I meet are truly the strongest women on the planet. So, having the ability to truly help these women – these families and provide them with comfort and relief, is more satisfaction than you can imagine.

As home care providers we are charged with a very critical mission: quality, ethical care that ensures the safety and well being of the client. For my team, it goes further than that – eliminate the headaches, stress and undue emotional pressures that families face when caring for a sick loved one. Now, imagine for just a moment being new to this country, learning the language AND having a child who requires round the clock nursing care. Thankfully, the Medicaid program provides this invaluable service that permits licensed agencies to send nurses into a home, thus eliminating the need for families to be without their children – having to deal with only visiting them in a home similar to a nursing home. It is a great program – but sadly abused by some agencies out there.

I am sickened, no, repulsed by the mere fact that there are agencies out there who are more concerned with the bottom dollar than the families. This mom was petrified that if she switched agencies (she is only receiving nursing care 50% of the time) that she would be harassed by the current agency manager, should she leave. In fact, on several occasions she has tried to leave and received continuous phone calls and even unannounced visits by the manager telling her to stay. She claimed that he would call her home, her cell phone and continue to beg her to stay.

What gives you the right to harass a family? The fact that your commission depends on it? Trust me, this is just ONE issue we have in home care today and it is ONE that will not be forgotten. So, to all of you out there who diligently follow my blog – to all of my competitors, those whom we support and those of you who read it merely to follow what we are doing... I will caution you. Treat your patients and their families with the respect they deserve. Home care is a service to assist them, not create more stress and headaches. If you are only in this business to make a living, find a new career. We are not checking out groceries – we are caring for people. If you are not sincere about their well being – do us all a favor and get out.