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Answers for Elders Podcasts: Brightstar Care

Kathy Lyons of Brightstar Care spoke with me about a very important subject: caregiver burnout. What is it? How do we prevent it? And how do we manage burnout if we’re already experiencing it? Brightstar Care provides home care to individuals with needs to maintain independent, in home living.

When asked, “when should a pro be brought in?” Kathy deftly noted,  “Usually when they call us, they’re already past the need.” A preventive way to think is, on this path of caregiving, what is my capacity a week, 3 months, 6 months down the road? Think about what you’re currently doing and if you think you can do this for another 6 months. If you find yourself exhausted or overwhelmed already, and thinking about the longevity is nerve-wracking, its time to start investigating. Calling in help is a sign of strength and protecting yourself, your loved one, and your relationship, not a failure!

Many people are afraid to seek home care professionals because of the financial aspect. We, of course, have to be fiscally responsible. However, don’t be pennywise and pound foolish. Don’t waste relational time doing the busy, overwhelming tasks that someone else could step in and do. Make fond memories, maintain or establish a fulfilling relationship, be present in the process. Even grieve WITH them. It’s so easy to get caught up in the day-to-day tasks, you resent other family members, and you’re not a happy camper and possibly even taking it out on your elder loved one. There is often shame with feeling this way. It’s so important to bring this topic to light, to discuss it and take away the stigma and the feeling of aloneness. Almost every caregiver experiences anger, frustration and being overwhelmed. It doesn’t have to be this way!

What exactly is home care, the service the Brightstar provides? It is truly individually tailored care to meet each family’s needs. It could be someone who doesn’t drive anymore and doesn’t have family members close. So we can provide that service. Lots of people don’t want to burden friends or trust taxis or Uber / Lyft providers. Also, having someone trained to help an elderly person, who might have mobility issues, in and out of the car is huge. ADLs (activities of daily living) can be assistance showering, transferring to a shower or bath, getting dressed, preparing your own meals.

Families used to be larger and more centric, so the burden of caregiving seldom fell to one person. Everyone would pitch in. Now, people have fewer children and families often move away. At Brightstar, we are a team. We are here to help different caregivers. Brightstar is Joint Commission accredited, which is not required for Home Care agencies. But they validate and verify we are doing the things we say we are. We also have nurses on staff who draw up the Plans of Care, outlining the activities and duties for each patient, every week. To contact Kathy Lyons for more information on caregiver burnout or how Brightstar Care can help, call her at 206-777-1190 or go to www.brightstarcare.com . Once there, input your zip code and it will direct you to her office if you are in or around North Seattle. (Servicing King County and south Snohomish County.)

To hear more of my conversation with Kathy, listen to  https://answersforelderscom.files.wordpress.com/2017/06/brightstar_warningsigns_podcast.mp3

For more information and resources for caregiving, go to

http://www.answersforelders.com/index.html

Answers for Elders Podcasts: Legacy Estate Planning

Stephen Waltar joined me to talk about Money and Law here at Answers for Elders radio. He is a renowned estate planning attorney in Bellevue, WA. Stephen walked me through numerous aspects such as Property and AssetsEstate Planning and Trusts. These legal terms can be confusing and complicated, but Stephen helps simplify these concepts. “I often have clients call me afterwards and say, ‘that wasn’t that bad.'” Visiting an attorney can be scary. And many people don’t like to think about, much less talk about or plan for, dying. But protecting yourself when you’re alive and protecting your loved ones when you pass away is what good estate planning is all about.

Estate planning can (but doesn’t have to) include wills, trusts, powers of attorney, and living wills. A will just says who gets what when you die. A trust helps protect your assets and reduces probatePower of attorney governs what should happen while you’re alive. It gives someone else authority to act as if they were you, whether making medical or financial decisions. (You can have different people acting on your behalf for different aspects of your life.) Who you choose for your power of attorney is not a popularity contest. It isn’t about loving one person more than another. It’s who you want making your decisions. A living will tells everyone (medical personnel, family members, et al) what you do or do not want to happen to you medically if you are incapacitated and unable to communicate your wishes. This helps alleviate guilt because you have clearly communicated your desires.

A lot of people try to avoid estate planning by simply adding a person (i.e. child) to their accounts. But this opens senior parents to be liable for adult children’s debts or actions. It is much better to draft a legal document, such as a trust, that a child can be the beneficiary or trustee of, instead. Powers of Attorney may also be needed between spouses. Many people erroneously believe in a community property state like Washington that if a spouse dies, the assets automatically go to the surviving spouse. Instead, it goes into probate. The surviving spouse cannot do anything (sell or refinance a house, for example) for mutually owned property until it’s probated.

One of the best quotes Stephen said was, “Don’t put your trust in money, put your money in trust!” There are several different kinds of trusts. Revocable trusts can be changed as your goals change. Irrevocable trusts cannot be changed. These may protect your beneficiaries from expensive taxes. It may protect your spouse who may remarry from losing the assets with which he or she would go into the next marriage. You can also put your house in a trust. This may avoid or reduce some estate taxes and streamline the probate process. You may also set up a Special Needs Trust to protect a beneficiary who is disabled and reducing government assistance. The trust protects them from having their much-needed benefits reduced or removed but allows the trust to help pay for additional expenses. There are many other kinds of trusts.

As to what is needed, the short answer is…it depends. It depends on what you have. It depends on your goals. It depends on who is getting what. Stephen will sit down with you for a free consult. But first, he asks that a questionnaire of “nosy questions” (his words, not mine!) be completed. that allows him to get to know what you’re coming in with, do some research, then really spend the consult getting to know you, listening to you, your goals and your needs.

For more of my delightful conversation with Stephen, go to https://answersforelderscom.files.wordpress.com/2017/05/legacy-planning-podcast-1.mp3

To contact Stephen, call 425-455-6788 or go to www.waltar.com .

For more information and resources for caregiving, go to

http://www.answersforelders.com/index.html

Answers for Elders Podcasts: Real Estate 55 Plus

Founder and CEO Juli Anne Gibson, of Real Estate 55 Plus, sat down with me to discuss the specializations required to market and sell homes for seniors in transition. While real estate often has cycles and busy seasons, adult children with seniors in crisis means that her team of agents stays busy year-round. Juli Anne has excellent information on what distinguishes this segment of the market, provides seminars to seniors and their families to work through the process of selling the family home, and advises on the right questions to ask real estate agents in order to find the right fit for you.

Selling a family home is emotional, at best. Trying to find the right home for a parent in the middle of a health crisis, financing the move, readying a home that may have been owned by the same person for more than 50 years, and working through the emotional attachments thereof requires a very specialized real estate agentReal Estate 55 Plus is not just another agency. Rather, they look for seasoned agents with specialty markets and areas (real estate is hyperlocal!) and with a passion and background for working with seniors. Then, they provide specialized coaching and consulting to help agents work through the financial, physical, emotional and spiritual aspects of a transaction for seniors and their families. Real Estate 55 Plus also works with and recommends contractors who can do roofing, HVAC, painting, staging and other necessary repairs and updates. These are contractors who have worked with them well in the past, offer discounts to seniors, or will allow payment after escrow, realizing some seniors do not have funding up front for the repairs necessary to sell their homes.

Juli Anne and her company also provide workshops to seniors and their families who are wanting to be proactive with their future living arrangements. The three Aging With Choice workshops offered are (1) What’s the Right Sized Home for My Life? (2) What Do I Do with My Stuff? and (3) Embracing the Change!

Another great piece of advice is on the questions to ask when interviewing real estate agents. Some of her top questions to ask include (1) Do you know [your particular] area? Keep in mind, you want an agent who not only knows the comparables in the neighborhood, but also one who has good relationships with buyer’s agents in the area. (2) With how many seniors have you worked? Remember, 90% of homes are sold by 10% of agents. So time in the business does not equal success or experience. (3) How well do you understand the distinct transition and transaction of seniors? (4) Ask for references from past clients! Then call them. Ask previous clients any questions or concerns you have about the entire process and experience. Other people’s testimony tells you more than anything.

For more solid advice and information from Juli Anne, listen to the podcasts.

https://answersforelderscom.files.wordpress.com/2017/05/real-estate-55plus-podcast-life-changes-and-transistions.mp3

Contact Real Estate 55 Plus at 1-800-964-1553 or email Juli Anne at juliannegibsonre@gmail.com. Find them online at www.realestate55plus.net

For more information and resources for caregiving, go to

http://www.answersforelders.com/index.html

 

Answers for Elders Podcasts: Mission Healthcare (a Careage company)

I was fortunate enough to have Beth Deems, community liaison for Mission Healthcare from Bellevue, sit down and talk with me about several crucial, and often difficult to Aunderstand, aspects of caregiving. Beth does such an amazing job of giving tips on fall prevention, understanding Medicare, defining skilled nursing and elaborating on continuum of care and makes it so easy to understand. Careage has more than 50 years experience of focusing on various aspects of senior living.

Fall prevention is one of the best things we as caregivers can do for our senior parents. And while it may not be possible to prevent all falls, mitigating that risk is so important. One in five falls results in a serious injury, such as broken bone or head injury, according to the Center for Disease Control. Even if the fall itself does not result in an injury, the inability to get up or call for help may result in complications, such as dehydration, pressure sores, or hypothermia, per the National Council on Aging. Falls may stem from changes in your parent’s gait. Balance, peripheral neuropathy in the feet, or dizziness due to medications are all things that can affect someone’s gait. Do you notice your parent furniture walking (holding on and moving from furniture piece to piece or the wall?) This could be indicative of a gait issue. Making sure they have good, comfortable shoes with sufficient tread and support is important. More causes of falls include throw rugs, uneven walkways, and clutter. Clutter could easily fall (especially with furniture walking) and cause unexpected obstacles. Good lighting is also important. These causes may be indoors or outdoors, so do a thorough assessment of the entire property. Bathrooms are a common room for falls. Installing preventive measures such as handrails in the shower, along the walls, and beside the commode could be useful.

If your parent has experienced a fall or illness resulting in hospitalization, your head may be swimming, trying to understand Medicare. Or maybe you are walking your senior loved one through the application process and need help understanding what it covers and what you need to buy. Fear not! Beth is here to help. First things first…this information is accurate as of May 2017. Like all Federal programs, it is subject to change. Medicare Part A covers inpatient hospitalization and inpatient skilled nursing rehabilitation on a short-term basis at 80%. Part B (an option for which you pay extra) provides outpatient coverage, including doctor’s office visits. Part D covers prescriptions. And Plan F is a supplemental policy you can buy to help cover things such as copays and the 20% that Medicare may not cover.  When it comes to hospitalization and getting covered to move from the hospital to a skilled nursing facility to do rehab, Medicare has very specific guidelines. The patient must have a “qualifying stay” of three days (three midnights) for which they were ADMITTED into the hospital. If your parent was only under observation, it does not matter how long they are in the hospital. You may have to advocate for your parent to be admitted, or to stay through the qualifying period. Otherwise, Medicare will deny coverage for the rehabilitation.

Once your parent has moved to skilled nursing, you may wonder what exactly that entails and why it is preferable to outpatient or in-home rehabilitation. Skilled nursing is not the same as assisted living or retirement living. Rather, it is focused on getting your loved one back to their prior living situation. By having 6 days of therapy a week (instead of 2 days, like in-home or outpatient,) the patient progresses faster and returns to more independent living. While in skilled nursing, measures of home comfort are so helpful to the rehabilitative process. Having comfortable workout clothes, photos of loved ones, cheerful plants, or a comforting quilt can help ease the mental and emotional stress of being away from home.

Finally, how do you understand and manage your parent’s potential ongoing care and living needs? Being able to predict the potential course of their needs is tricky. That’s where Continuum of Care comes into play. Selecting a facility that can help your loved one transition easily as their needs change may be the right move. A Continuing Care Retirement Community (CCRC) can work with your parent as they progress from needing simply assisted living (not round-the-clock nursing, but help with meal preparations, dressing, and other Activities of Daily Living (ADL)) to skilled nursing (higher level of nursing need) to Memory Care, such as for patients with Dementia or Alzheimer’s.

Beth Deems and the wonderful staff at Mission Healthcare and other Careage facilities are happy to answer your questions and walk you through the options and process of finding the ideal living scenario for your parent. For more information, contact Beth at 206-930-2873 or bethd@missionhealthcare.com. www.missionhealthcare.com .

For more details on these important issues, listen to

https://answersforelderscom.files.wordpress.com/2017/05/careage-fall-prevention.mp3

For more information and resources for caregiving, go to

http://www.answersforelders.com/index.html

Answers for Elders Podcasts: Serengeti Care

Josephine Mporokoso, of Serengeti Care, was kind enough to come in studio with me to discuss two very important issues in the caregiving arena: Managing caregiver burnout and understanding Long Term Care insurance. Josephine is a Registered Nurse and case manager with 10 years’ experience.  Serengeti Care offers home care services (such as bathing, dressing, light housekeeping and incontinence care,) home health services (like occupation therapy, physical therapy, or speech therapy,) and case management to enable your senior loved one to remain in their own home, safely and with dignity, for as long as possible.

Most people who become caregivers to a parent or senior loved one find this role very suddenly and abruptly thrust upon them. It is overwhelming, can be disruptive, and affects generations of people within the family. Burnout is very common among caregivers because it is such a stressful undertaking. Many people experience burnout but don’t really have a name for it. Or caregivers feel guilty for experiencing burnout that they aren’t willing to admit or discuss it. Symptoms of burnout may include shortness of breath, cramps, knot in the throat, anxiety, feeling overwhelmed, or feeling out of control with your own life.  Heart disease and high blood pressure among caregivers is twice as high as the national average. And 23% of caregivers providing care for loved ones for 5 or more years rated their own health as fair or poor.

But there is good news! Burnout can be prevented, managed, or alleviated. You are not alone! Nor do you have to do it all. Preventing and managing burnout may mean setting schedules and boundaries. Alleviating it may require you to step away from the situation, even if only for a few minutes. Having positive thoughts or using music as therapy can also help. Talk to someone, find support, ask for help. Utilizing service providers such as Serengeti Care can reduce the stress and busy work, allowing you to focus on the relationship, spending quality time and creating memories. And believe it or not, it is possible, even important, to see gratitude in the midst of this most difficult task.

We’ve addressed burnout. But another hard aspect of providing care for our aging parents is figuring out how to do it financially. One avenue is if your senior loved one has a Long Term Care (LTC) insurance policy. This is not only good information for you as a caregiver, but also to know for your own potential future care as you age. Josephine notes that many Long Term Care plans cover home care. (Medicare does not pay for non-medical in-home care such as laundry, housekeeping, companionship, etc. that are still vital aspects of allowing seniors to live independently at home.) Service providers like Serengeti Care will be happy to review the policy and help you understand what it covers.  More importantly, they can help you understand up front before you use the services, only to learn down the road whether the services were covered. And best of all, if services are covered by the LTC plan, Serengeti will bill insurance directly instead of you having to front the money and get reimbursed for covered expenses.

Experienced nurse and case manager Josephine Mporokoso and the team at Serengeti Care would love to help you understand more about managing burnout, best utilizations of your parent’s LTC plan, and other ways in which they can help you and your loved one maintain a safe and dignified aging in place experience.  Listen for more to her Answers for Elders podcasts.

https://answersforelderscom.files.wordpress.com/2017/04/serengeti-care-burnout-podcast.mp3

To contact Josephine and Serengeti Care, go to www.serengeticare.com or call at 206-755-1200. They are available 24/7.

For more information and resources for caregiving, go to www.answersforelders.com .

Answers for Elders Podcasts: Team Zugel

Jaden and Valicia Zugel graciously joined me to discuss several aspects of realty as it relates to aging and caregiving. Married for more than 10 years, they have two delightful children and live down the road from each set of parents. Jaden has been in realty since  2003, while Valicia joined more recently. Jaden and Valicia have a passion for working with families to help make real estate decisions. This passion is deeply personal for them both, as they each experienced a grandparent who needed care. I sat down with them to discuss some trends and issues in realty and senior living, including multi-generational living, aging in place, and transitioning our senior loved ones effectively and efficiently.

Valicia’s grandfather suffered from Alzheimer’s. To honor him, and the sacrifices made both in her family and in Jaden watching his mother invite her own mother into their home to live and care for, Team Zugel donates $100 from every house they sell to the local chapter of the Alzheimer’s Association.

Multi-generational living, aging parents co-habitating with adult children and their families, is a relatively new trend in America, increasing by a whopping 30% from 2007-2014. What started as a financial necessity is now a choice many families are making. And people in the real estate business are taking notice. Some builders are now, essentially, building two homes in one. Features may include dual master suites, doorways and hallways already widened to code for wheelchairs and walkers, ground floor master rooms for the older generation, easy accessibility, and fewer stairs. Assets like this from the beginning make staying or returning home easier as it becomes necessary down the road. Asked when the right time to move into a multi-generational home, Jaden replied, “Before you have to.” Benefits to this living arrangement can include grandparents helping with children, cleaning, or cooking, while adult children are able to manage their parents’ health, go to doctor’s appointments and provide safe transportation. This lifestyle shift, common in other parts of the world, can also bring deeper appreciation for one another.

Aging in Place, staying in your home in your twilight years, is another aspect with which Team Zugel can help. Instead of considering selling the family home as “downsizing,” Jaden prefers to think of it as “right sizing.” Reducing the amount of time and money maintenance takes, lowering property taxes and limiting the square footage to what is actually used makes sense for a lot of families and allows loved ones to live out their remaining years at  home instead of in a facility. There are senior communities which provide single family homes (as opposed to retirement center apartments) but offer therapists, doctors, and transportation all within a small radius. Other ways to age in place include using smart technologies such as monitors, fall sensors, water temperature controls and automatic shut-offs on appliances.

Moving your parent to or from a home can be difficult, but it doesn’t have to be. Selecting the right realtor can help manage tricky aspects of transitioning seniors such as evaluating multiple offers (with the current housing climate.) Determining the buyer with the right financing and the right offer (i.e. making sure the home will appraise) is important. A realtor that can assess and recommend low-cost changes to maximize profits, such as updating fixtures, painting, or replacing worn or dated carpet is so useful. It can be easy to get overwhelmed or feel that an entire gut job is necessary when it may not be needed.

Valicia and Jaden have many excellent tips and ideas. For more, listen to their Answers for Elders podcasts.

https://answersforelderscom.files.wordpress.com/2017/04/team-zugel-podcast-11.mp3

To reach them for you or your senior loved one’s realty needs,  contact them at

http://teamzugelrealestate.com/

For more information and resources for caregiving, go to

http://www.answersforelders.com/index.html

Welcome!

Welcome to the Answers For Elders blog page! I am here to explore this scary, unknown, daunting, yet potentially beautiful and precious journey of providing care for a loved one. One of the most common relationships for people on this journey is that of parent and child. Except this time around, the child is taking care of an elderly parent. But whether you are caring for a parent, grandparent, aunt or uncle, dear friend, or a spouse who has been diagnosed with a condition that changes their independence, the relationship has changed. It’s okay to mourn the loss of what was. It’s also okay to embrace the new reality. It can be an incredible experience.

If you’re new to caregiving, I know you have a lot of questions and fears and doubts. I did, too. You wonder about the time commitment. You wonder about keeping your loved one safe, especially when you’re not around. You wonder if it’s okay to feel sad for the loss of the relationship as it used to be, as it was for so long. You wonder if you’re selfish for feeling like you’ve lost your independence and the freedom attached to the life you worked so hard to build that is now so disrupted. You wonder if you’re allowed to be happy to have them alive and with you, yet be so frustrated and mad at the same time, because they aren’t listening or are tempermental and argumentative. You get upset when you have to explain the same thing repeatedly. And you cherish just sitting with them on the couch, holding their hand, watching reruns of a show from 60 years ago.

The answer is…yes. It’s all okay. It’s okay to be happy and angry, sad, fearful, joyful and protective. You’ll probably feel all of these at least a few times. I want to help answer some of the practical questions of what you may need to do to protect and provide for the elder in your life. I want to help alleviate loneliness and guilt. I want to connect you with the people who can help this newfound path be the best possible path for you and for your loved one.

Each month, I’ll focus on a particular topic regarding caregiving and what it means, both to you and your loved one. Click the “Follow” button below to get updates on new blog posts and go to http://www.answersforelders.com for caregiving resources and an online community.

 

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