Elder Care Home Health Blog » Caregivers

Long Term Care Insurance – Elimination Periods

admin — Fri, 03 Feb 2012 12:00:53 +0000

We Urge You to Look at Your LTC Policy Before You Need It and Check about Elimination Periods and Your Daily Benefit.

Many of our clients at Boca Home Care Services, Inc. have Long Term Care Insurance. They use their policy when personal care and household assistance following a fall, accident, illness or surgery is needed. The client may be returning home from a hospitalization or Rehab stay, compounding a stressful and busy time of coordinating care while recuperating.

It’s not unusual for people to forget that the policy they purchased has an “Elimination Period” which likely lowered their premium payments. However it means home care coverage does not begin right away, but after the “Elimination Period” is met. Let’s face it, few people remember the terms of their insurance policies. As time goes by, details fade. It’s an expensive “surprise” through which time you must pay out of pocket for the care you need. Insult to injury, usually the most help is needed at the start of care.

“Elimination Periods” can be a few days, a few weeks or even a few months. If you require live-in or substantial care, the costs can be thousands of dollars – you didn’t expect to pay.

Boca Home Care Services, urges you to familiarize yourself with your Long Term Care Policy BEFORE you need to use it. Call your agent or the company and review the terms of your coverage. If your policy has an “Elimination Period”, plan accordingly. Suggestions include: setting funds aside to cover the period you would have to pay out of pocket expenses for your care, put together a plan with family, neighbors and friends of who can help with which tasks. If some people can do the shopping, bring in cooked dishes, and take you to appointments, then you may need a Home Health Aide just for personal care such as bathing, dressing, respite time and laundry. In this way, you may be able to manage with only the minimum hours from an Aide. Research which food stores, restaurants and pharmacies deliver in your neighborhood.

Lastly, some policies will count days in a Rehabilitation facility and Medicare home health visits (Boca Home Care) towards the “Elimination Period”. Explore these possibilities with your insurer. Ask what paperwork is required to have these Rehab and Medicare visits count

How to limit Alzheimer’s wandering

admin — Wed, 01 Feb 2012 12:00:53 +0000

By Elizabeth Cohen, Senior Medical Correspondent/updated 11:34 AM EST, Thu November 10, 2011

A hallmark feature for some people with Alzheimer’s Disease is wandering which is scary for the caregiver and potentially very dangerous. Here are some tips and things to look out for should your loved one be a wanderer with dementia.

Tips to prevent or tract people who have Alheimer's Disease and wander.

People with Alzheimer’s and other forms of dementia often leave clues that they’re about to wander.

(CNN) — It was early evening when Lee Ferrero got in his car to make the trip home from a meeting for work. He’d done the trip many times over the years, and he looked forward to the drive.

Several hours later he found himself in open farmland in unfamiliar territory. He pulled over, brought out a book of maps, and realized he’d driven two hours past the turnoff to his home in Los Osos, California.

“It was terrifying,” he remembers now. “I thought, I didn’t mean to come here. How did this happen? I just zoned out.”

But he wasn’t just zoning out. A visit to the Mayo Clinic in Scottsdale, Arizona, showed Ferrero was in the beginning stages of Alzheimer’s disease, a form of dementia.

“That car ride was a real wake-up call,” he says.

After his trip to Mayo, Ferrero’s wife insisted he get a professional driving evaluation to make sure he was safe to drive. His driving was fine — the only problem was that he might wander off again down the road.

It has been five years since that fateful car trip. The disease forced Ferrero, an Air Force veteran, to retire from his position as president and CEO of the Private Industry Council of San Luis Obispo County. Now 64, he doesn’t want to sit home all the time, and still drives and walks around.

To decrease the chance he’ll wander again, Ferrero writes down exactly where he’s going so he can refer to it later, and he wears an ID bracelet with a 24-hour emergency response number. He hasn’t had another wandering incident, but knows he might at some point as his disease progresses.

“I forget things I never used to forget and I know it’s only going to get worse,” he says.

November is National Alzheimer’s Disease Awareness Month and Family Caregiver Month. About 60% of the nation’s 5 million Alzheimer’s patients will wander, according to Beth Kallmyer, senior director of constituent services at the Alzheimer’s Association.

“This is such a big worry for families,” she says. “We tell them their loved ones can wander off at any time, even when you just go into the kitchen for a minute to start dinner.”

Kallmyer advises families that there’s no way to keep an eye on someone 24-7, but that there are some steps they can take to decrease the chances their loved one will wander.

1. Keep wandering top of mind

Sometimes families are surprised when their loved one wanders. Lawrence Schonfeld, an Alzheimer’s expert, has noticed sometimes families forget that wandering is a huge risk because they’re so overwhelmed with other aspects of Alzheimer’s disease.

That can be a fatal mistake.

“Families are worried their loved one will leave the stove on in the kitchen, or they’re annoyed when their loved one asks the same question over and over again,” he says. “Wandering isn’t always their major concern.”

2. Pick up on the red flags of wandering

Wandering can happen at any time, but it’s more likely in certain situations, such as when someone with dementia is in unfamiliar surroundings.

People with Alzheimer’s and other forms of dementia often leave clues that they’re about to wander. If your loved one says, “It’s time to go to work,” she might truly be headed out the door in a few minutes. “I want to go home” might mean he’s about to go in search of his childhood home, and you have to stop him.

3. Distract them

Don’t say “Dad, you haven’t worked in 30 years,” or “Mom, you’re already at home.” Reasoning won’t work. Instead, distract.

“If they say they want to go to work, tell them ‘OK let’s go see if we can find your shoes,’” Schonfeld suggests. “By the time they get their shoes on they’ll have forgotten about going to work.”

4. Block (or disguise) the exits

For safety reasons, you should never lock or trap a person with dementia in a home alone. If someone is there with them you can block the doors. There also are screens you can buy that look like, say, library books, so your loved one won’t realize it’s in front of a door. You can also put a lock toward the bottom of the door; Kallmyer says people with dementia won’t think to look for a lock in such an unusual place.

Another idea: Put a mirror or a stop sign on the door, or you can try putting a dark rug in front of the door. People with late-stage dementia might think it’s a hole and won’t go near it.

5. Label your rooms

Sometimes people with dementia will go wandering off in search of the bathroom or a glass of water and get distracted and actually leave the house. The Mayo Clinic suggests putting a picture of a toilet on the door to the bathroom or food on the door to the kitchen, so they can more easily find what they need.

6. Keep them busy

“Sometimes people wander out of boredom, or because no one’s paying attention to them,” Kallmyer says. “Spending a lot of time watching TV isn’t good. Have them wash dishes with you, or fold clothes.”

You can also enroll your loved one in an adult day care program so they’ll have interesting activities. Seniorresource.com and Eldercare Locator have search tools for finding a program near you.

7. Take a walk

“Have them take a walk or exercise with you,” Schonfeld suggests. “They may be so tired afterwards they’ll want to sit for a while.” Even if they’re not tired, the social engagement of the walk might be enough to keep them from wandering in search of company.

8. Provide safe wandering

Create a path through the rooms of your house as a place for your loved one to wander, or a circular trail through a fenced backyard, the Mayo Clinic advises.

GPS shoes track dementia patients

9. Consider technology

Some devices alert you if a door is open in the house. Others tell you if your loved one has wandered beyond a certain area. You can even attach a GPS to your loved one and then go online to find him on a map; the GPS might be on a bracelet or in a shoe.

The Alzheimer’s Association has an overview of electronic devices that can help keep track of Alzheimer’s patients, and the association also has information about the ComfortZone and other safety products it sells. American Health Assistance Fund has a partial listing of companies that sell safety products. These devices can be expensive and some have a monthly service fee.

10. Find the right facility

Many families aren’t sure they can safely keep their loved one with dementia at home. The Alzheimer’s Association has a guide to determining what kind of care you need, and a guide for finding nursing homes and assisted living facilities.

Schonfeld recommends you check out a facility to see whether it has any complaints against it, especially those that involve wandering. The National Long-Term Care Ombudsman Resource Center has a list of state ombudsmans’ offices, which can help you find the complaints.

Be sure to ask the right questions.

“Is the door monitored, either electronically or by staff?” Schonfeld says. “Do they have electronic devices to keep track of people who wander? And ask about their strategy for what they do if someone does wander off.”

Aaron Cooper and John Bonifield contributed to this report.

Read more: http://www.cnn.com/2011/11/10/health/alzheimers-lost-empowered-patient/index.html?hpt=hp_bn10

Private vs. Licensed Home Care

admin — Fri, 27 Jan 2012 15:45:47 +0000

Once the decision is reached to that a home health aide or caregiver is needed one has to decide whether to hire privately or go with a licensed company. There is a lot more to consider than price so you must know your responsibilities as an employer or as a client. Also, Long Term Care insurance may come into play.

A cautionary tale learned the hard way. Every now and then a client decides that they will hire someone privately who someone in their building used. It is cheaper after all-although as the employer of the privately hired aide, you are legally responsible to pay Social Security and other Federal taxes- remember “NannyGate”?

Last week, a client did just that, they decided they wanted to save their insurance, hired someone referred to them and discontinued service. Two days later Boca Home Care Services received a call from the hospital from this client. Her new aide whom she hired on her own didn’t stay with her or come when called so the client attempted getting to the bathroom on her own, fell, is severely bruised along her left side. Thankfully, nothing was broken, but her spirit.

Of course this scenario can happen with the best of care however, the client had no recourse. She couldn’t call the office and ask for a new caregiver. No one could speak to the aide and set a higher standard. The client learned the hard way, she was on her own. We were back on service in the hospital that day. Even though her LTC insurance doesn’t cover in the hospital, she wanted one on one help in the morning to start her day.

There are tangible, important advantages to hiring a caregiver through a licensed company. You have back up in case the caregiver cannot work or they change schedules. The aides are screened and credentialed. There is accountability and transparency. When you or a loved one is incapacitated these things are worth the cost.

Six Steps to Reduce Stress to Calm Your Mind, Body & Spirit

admin — Mon, 23 Jan 2012 12:00:30 +0000

We Know about Relaxation and Other Stress Reducing Techniques. The Trick is to Practice and Master them to help Reduce the Stress We have and the Continual Stress of Caregivng. Review Some Basic Tips to Calm Yourself During the Day.

Caregiving is one of the most stressful responsibilities imaginable. You are responsible for the care of another adult who may be in pain, resentful, depressed and uncooperative, all adding to the stress of being a primary caregiver. Even with a hired home care aide, managing the finances, appointments, and your own health add up to a stress filled life.

No secrets here, you’ve heard it before, the trick is to take the time to practice these Stress Reducing Tips daily so they become a part of your routine and the benefits become a part of your life.

• Change your breathing patterns to invite relaxation. Breathe in deeply, hold briefly and then exhale completely.

• Stretch your arms, legs, bend from side to side and stretch your neck to release tension in your body.

• Try Meditation* or Prayer at least once a day. Pick a quiet location, close your eyes and focus your mind. Chant if that helps you to deepen your concentration.

• Consciously decide to eat healthier foods. Add something, a fruit or vegetable to your diet.

• Gain quality sleep. Find a way to sleep or nap regularly.

• Smile, Smile, Smile more often and laugh more.

Give your brain a minute to relax and not take in information. Try a one minute meditation:

Sit in a relaxed position and close your eyes.

Concentrate your mind on a safe place- beach, park, cozy bed, and bath – somewhere you feel relaxed.

Count backwards from ten to zero.

As you are counting, focus on the numbers, breathing or your thoughts. Feel the countdown to a more relaxed state.

Remember – practice makes better!

Home-Care Services May Become More Costly

admin — Fri, 20 Jan 2012 12:00:29 +0000

An Obama proposal would make home care more costly by allowing for overtime pay to caregivers. This will effect hours of care, number of caregivers, Long Term Care insurance coverage and possibly evenallowing people to remain at home. Take Action and communicate to your representatives.

The Miami Herald > Opinion > Letters to the Editor

Letters to the Editor * Friday, 01.06.12

Home-Care Services May Become More Costly

Millions of seniors enjoyed the holidays, thanks in large part to the affordability of trusted licensed home healthcare givers who provide daily critical assistance, be it medication reminders, dressing or cooking.

But as early as March, barring a reversal of an executive order from President Obama, the quality of life enjoyed now by many seniors could be adversely affected both in their independence and checkbook.

Under the president’s Dec. 15 directive to the Department of Labor, home health aides, exempt from federal wage laws since 1974, will have to be paid an hourly wage and overtime for service over 40 hours a week.

Don’t expect insurance policies to extend for this added cost. If the consumer pays out of pocket for all home care now, the cost could be staggering. Imagine paying a licensed, trained and background-checked home health worker, now costing $17 an hour, $25.50 an hour for 30 hours of overtime. Weekly, that added expense would be $247.50 and yearly it could be almost $13,000.

The options are not pretty:

• Individuals may give up their independent lifestyle and shift to institutions that until now were more costly.

• Children paying for or monitoring a parent’s expenses might start hiring independent caregivers, skipping over companies that provide credentialed caregivers.

• To get around overtime, individuals may choose to create a revolving door of caregivers. This won’t make the client particularly happy either. “Don’t send me anybody else,” is a familiar directive to home healthcare providers such as myself.

A relationship between the caregiver and senior can determine if the senior is comfortable enough to go on an errand or an activity with an aide or choose to stay home, shrinking their world and opportunities for happiness.

Individuals who provide this important work for our growing senior population should be fairly compensated, but at what cost to the consumer? There must be balance.

The Department of Labor has opened a 60-day public comment period ending Feb. 27 before acting on the president’s initiative. Concerned South Floridians should call President Obama and their congressional representatives to express opposition to the anticipated negative impact.

Joseph Bensmihen, owner and CEO, Boca Home Care Services, Boca Raton