Wednesday, April 14, 2010

Benefits for Seniors

I recently found this article in The New York Times and wanted to pass it on as quickly as possible. I hope it provides some assistance in navigating through the often muddy waters when it comes to health care and seniors. This is an AP article published April 2.

A clear goal of the new health care reform law: increased access to home-based care.

Last month's health care law contained some benefits for the nation's older population. It provided long-term care options to allow more seniors to stay in their current homes rather than seek institutionalized care, and called for more publicly available information about nursing homes.

Most seniors prefer to stay where they are than move into assisted living or a nursing home. AARP surveys show that roughly nine out of 10 senior adults prefer to ''age in place.'' But, in many cases, health issues force a senior to seek out a facility where they receive individualized, round-the-clock care.

Parts of the new law help seniors and their families navigate such difficult situations.

The most high-profile provision related to long-term care in the new law is the Community Living Assistance Services and Supports act, or CLASS. It will allow adults with mobility problems to receive home care through a voluntary insurance plan. A handful of other programs will improve access to home and community-based services to complement CLASS, including one that provides matching federal dollars to states that expand their home care services.

And, the legislation requires that nursing homes report important information like staffing data, so families can make informed decisions about where to place their loved ones.

''The key thing to realize is the health care reform bill actually has probably a couple of dozen opportunities, all told, to think differently about aging successfully,'' said Dr. Bruce Chernof, president of The SCAN Foundation, a nonprofit proponent of long-term care for seniors funded by SCAN Health Plan, a Medicare Advantage plan.

The number of Americans over 65 will mushroom in the coming decade, as roughly 75 million Baby Boomers reach retirement age. Their long-term health care needs will strain the nation's collective wallet, stretching thin programs like Medicaid and Medicare.

AARP reports that it costs as much in Medicaid dollars to care for one person in a nursing home than it costs to care for three older adults and people with disabilities in home and community-based settings.

Meanwhile, more than 10 million Americans are currently in need of long-term services that help them function in their daily life, and that number is expected to rise to nearly 15 million by 2020, according to the National Council on Aging.

Enter the CLASS voluntary insurance program.

Under CLASS, working adults who need daily assistance would have at least $50 per day to pay for home care -- more if the adult has a higher level of impairment. After five years of paying into the program, recipients could use the money to pay for a home health-care aide.

CLASS funds also can be used to pay for adult day care, transportation, and safety features like grab bars and handrails. They also can be used to help pay for assisted-living facilities and nursing homes.

Seniors who enroll in CLASS will have a better chance to remain independent and active in their communities. That provision also helps their caregivers, who in many cases are adult children who may feel they are spending too much time and money looking after their parents.

CLASS includes protections ensuring the program will be solvent for 75 years, and could result in Medicaid savings in the long haul.

Another benefit to seniors is a collection of programs that improve access to Medicaid's home- and community-based services but which aren't a voluntary insurance plan like CLASS.

For example, the Community First Choice program creates a state-based plan to keep people with disabilities who require an institutional level of care out of nursing homes by providing them with home-based attendant services. States will receive federal matching funds if they adopt this program.

Another program increases funding for Aging and Disability Resource Centers, which offer information and counseling about the various long-term health-care options available to seniors. And, another provision protects spouses from being forced to spend all the couple's assets to get access to home- and community-based care, similar to benefits already in place for nursing home residents covered under Medicaid.

These programs are meant to keep the senior at home. For those who have no alternative but to move into a nursing home, there's something for them, too.

Nursing homes will be required to submit ownership information, staffing data and other items to increase transparency and accountability. People will be able to search the Nursing Home Compare Web site (found at www.medicare.gov) and find information on quality of care, consumer rights, staffing and other issues to help them choose a nursing home.

The Obama administration's reform effort is not the definitive answer to seniors' health care needs. Just call it an important first step in providing long-term, home-based health care for America's older adults.

Should you or a loved one need a helping hand right now, please call us to help provide care with a family touch, giving you peace of mind. Our number is 214-389-9401 or visit our website @ www.hereforyouhomecare.com.

I hope you found this helpful. I'll be back soon,
Jan

Tuesday, March 30, 2010

Out of Africa

I think it's about time to introduce you to my mother-in-law.....we'll call her Jean for privacy purposes. She lives in Albuquerque and is quite independent and active for an 85 year old woman. To tell you the truth....she's in great shape for a woman many years her junior. I hope to be doing so well when I am in my 80's.

Jean has lead quite the interesting life. She was born in a relatively small town in Texas. But she married a career air force officer and has traveled the world during and after his service. They lived in 8 different states in this country as well as in France, Japan and Taiwan. In fact Chris was born in Japan and graduated from high school in Taiwan. They eventually retired in New Mexico because the weather and flying opportunities were so wonderful there.

I won't tell you right here and now about all the fabulous places Jean has been, but I will tell you about a few. Among the more memorable trips in recent years was one to the Galapagos Islands. Now mind you this involved getting off and on a small boat to visit the islands and even sleeping on that boat. As I recall, there was eating of some pretty exotic food also. Another adventurous trip included Southeast Asia and sleeping on a water barge during some rather extreme weather conditions. My personal opinion...Jean is one tough cookie and loves to travel and continuously learn new things.

Her most recent trip was to Morocco, another relatively exotic locale. She stopped in Dallas to visit on her way going and coming back. So we were able to hear about her plans before the trip and then about the adventures she had actually experienced upon her return. There were many bazaars, the typical Moroccan architecture, multiple medinas and of course the colorful pots, scarves and rugs. Take a look at http://www.travelblog.org/Africa/Morocco/Marrakech-Tensift-El-Haouz/Marrakech/photos-page-1.html for some truly amazing pictures of the country that I found on the web. Her favorite city was Marrakech and she rode the proverbial camel through a horrific dust storm to watch the sunset. All in all it was a lovely tour involving travel on a bus with about 30 people from multiple countries (all of whom spoke English) and their tour guide.

Chalk that up as another country Jean can cross off her list. What's next....a question she was asked quite often by a fellow traveler? Who knows what adventure awaits the fearless Jean. We should all be as lucky as Jean.....to enjoy good health and exotic travel into our 80's. I know all of you are very healthy and energetic, but if you know of someone who needs a helping hand, then please have them call our office for a free consultation.

Take a look at our website at www.hereforyouhomecare.com and see how we can help. Call 214-389-9401 today for help with personal care, homemaking, companionship or respite care. Thanks for listening and I'll be back soon. Please make a comment if there is something else you would like to know or if you have a similar story to tell. Until next time,
Jan

Tuesday, March 16, 2010

Symptoms of Caregiver Burnout

I decided to branch out a little from my usual personal story telling and provide some important information. I am attending a monthly support group for caregivers. Even though I don't currently assist with my dad's day to day personal care.....thankfully he doesn't presently need that.....I help him daily with something. I help with everything from paying his bills to looking up phone numbers to reminding him to take his medication and to stay hydrated. So I have found it to be extremely eye opening to attend these classes.

While I have learned a lot from the instructor, I have also learned from the other attendees. And just hearing the stories of other caregivers has helped me to appreciate my own situation and family. So many people across the country are struggling with helping their aging parents. I guess one thing that has surprised me the most is how often the children squabble among themselves about how to help their parents and who will do it best.

One handout I recently received was Symptoms of Caregiver Burnout . This list is courtesy of the Area Agency on Aging 2005 Family Caregiver Education. It includes:
1. Disrupted sleep patterns.
2. Altered eating patterns.
3. Increased sugar consumption or use of alcohol or drugs.
4. Increased smoking or strong desire to start again.
5. Frequent headaches or sudden onset of back pain.
6. Increased reliance on over-the-counter pain remedies or prescribed drugs.
7. Irritability.
8. High levels of fear or anxiety.
9. Impatience.
10. The inability to handle one or more problems or crises.
11. Overreacting to commonplace accidents.
12. Overreacting to criticism.
13. Overreacting with anger toward a spouse, child or older care recipient.
14. Alienation.
15. Feeling emotional withdrawal.
16. Feeling trapped.
17. Thinking of disappearing or running away.
18. Not being able to laugh or feel joy.
19. Withdrawing from activities and the lives of others.
20. Feeling hopeless most of the time.
21. Loss of compassion.
22. Resenting the care recipient and/or the situation.
23. Neglecting or mistreating the care recipient.
24. Frequently feeling totally alone even though friends and family are present.
25. Wishing simply to "have the whole thing over with."
26. Playing the "if only" games; saying over and over "If only this would happen: or "If only this hadn't happened."

Wow...26...that's a lot. I think I have felt 1 or more of those even before I was a caregiver. But we do experience so many feelings and emotions when we are providing care for a loved one, even if it is from afar. We must take care of ourselves first in order to be able to care for others. Please look out for yourself. If you need a break or want to get away, then please call us. Let us provide some much needed respite care. Call us at 214-389-9401 and be sure to visit our website at www.hereforyouhomecare.com for more information and tips.

I'll be back soon with more personal news. Until next time,
Jan

Monday, March 8, 2010

Time to say "goodbye."

With my dad safely back at home in Houston, we spent our week working and closing out the end of the year. We had a nice time with our daughter as she finished her vacation with us and prepared to leave for South America. December 31st arrived and we were off to Houston for some final activities.

Early Thursday morning the 3 of us headed out. Our first stop was my old house, the setting for our previous adventure "Operation Clean Sweep." It looked unbelieveably good. It's amazing what a fresh coat of paint, clean floors and removal of years' worth of trash....I mean treasure can do for an old house. The men were still working and updates would be needed, but for the first time I could actually see the house becoming a new dream home for another family.

Next stop a quick lunch at Los Tios. Nobody does Tex-Mex or makes chile con queso "puffs" like they do. Then it was on to see Dad and his new digs. Of course Chris and I had been there before, but our daughter "C" had not. And obviously since we were in Houston, we wanted to see Dad again. We helped him move some furniture, dropped off a few things, visited and were soon out the door. Again, he was not ready yet to see my mother's grave. It was still too painful and emotionally "raw" for him. So we would be going alone.

We stopped a few places, but could not find appropriate flowers for her grave. We had to visit empty handed. But I was so pleased when we arrived. My mother is buried in a National Cemetery because my father had served in the military. Just like at Arlington National Cemetery, wreaths had been placed at all the graves. It was a beautiful sight.

Thanks to modern technology and the site locator, we quickly found my mother's final resting place. I took some pictures and we paused to pay our respects and to say goodbye. Sadly, there were already 3 or 4 new rows of additonal sites for people who had died and been buried since my mother's passing. So many WWII veterans and their spouses are dying every day. We were very pleased with everything we saw and felt comfortable with this cemetery. We had been there for the service in October, but it was held at a central location. Loved ones cannot visit the grave until after the burial and the marker is placed several weeks later.

On to the airport for another farewell. "C" was leaving for a school trip to Chile for 3 weeks. She would then be going back to grad school in California, so again I had to say goodbye. I can tell you now that she had a fabulous trip, learned a lot and loved the people. I am so thankful she was back before the big earthquake, not that California doesn't have its share of problems. I always cry for about 2 minutes, but then I bounce back and am fine. I am grateful for the time I am able to spend with my children, but am pleased that they spread their wings and are off doing what they love.

Last stop....back to my brother's house to pick up a piece of furniture and the last of the memories from my old home, my parents' house. We had not been able to bring back everything from the house when we had cleaned and emptied it earlier in December. We had stored some things at my brother's. We had a quick visit with them, loaded the car and off we went.

A four hour drive and a quick stop for dinner later, we were back home in Dallas. We even arrived home in time to watch the ball drop and toast in the new year with a glass of champagne. It had been a long and emotional day, but also one filled with satisfaction and accomplishment. I was able to say goodbye to several places and people and to feel contentment with life moving on and the cycle it follows.

Next time I will write about another family member and her incredible journeys at the age of 85. Don't worry...I will keep you posted on my dad and his antics. He attended the Houston Symphony recently and can now cross that off his "Bucket List" so to speak. He had not been there in years.

Thanks again. Until next time,
Jan

Saturday, February 20, 2010

"Wrapping up the Christmas Story"

So I left off last time with my dad greeting me on Christmas morning with, "I'm going home tomorrow." I asked him how he was going to get there. I had not bought him a roundtrip airline ticket. His plans and ours were up in the air, so we decided to play it by ear. I knew for sure that we would be driving back to Houston on December 31st to take our daughter to the airport. She was going on a school trip and flying from there. He announced that he was going home on the bus. He had not liked going through all the security for his flight up here. After running myself ragged making a lovely stay for him, I thought he could at least have said, "Merry Christmas" and then "I'm going home tomorrow." But that's just the way he is. But it did upset me and hurt my feelings....I do tend to take things personally. I was also a little concerned about his safety since he can't see very well.

So we called some other relatives and they all thought it was a great idea. We looked everything up online, bought his ticket and found someone to pick him up at the bus station the next day. It was going to be an interesting experience for him. We enjoyed the rest of the day opening gifts and having dinner with other friends and family. I was, however, a little disappointed that after staying up until 3:30 the night before to finish preparing the new photo album with all the family photos from his house, I was told that he didn't want it now. It just made him too emotional and he was not prepared to deal with that yet. While I was disappointed and tired, I could certainly understand that and am happy to keep it for him until he is ready.

Saturday morning we all headed downtown to take my dad to the bus station. We arrived early and waited in line for him, so he could get a good seat up front. Once we saw him safely onto the bus, stocked with a banana and Gatorade, we headed out. I have to admit that while I enjoyed loving on and taking care of him for 10 days, I was also glad to have a little bit of alone time with our younger daughter. She had not been able to come and be part of "Operation Clean Sweep" earlier in the month, so I had not seen her in quite a while.

Guess what......about 2 hours later Dad called from his cell phone. After departing late because the bus needed repairs, the new, good bus had now broken down. They were stranded about an hour south of Dallas. According to my father, the bus driver had no means of communication. But a 2nd bus came along and picked up his bus driver and drove off. My father had to ask other passengers, because he could not see well enough to know exactly what was happening. They were hoping that their driver could convince the other bus to come back and pick them up.

Meanwhile I began calling the folks in Houston to inform them of the problem and delayed arrival. I was about to head out and go pick my dad up and bring him back to our house. Sure enough he called again and he and his luggage were safely on the new bus headed down to Houston. This was not an express bus and would make multiple stops, but who cared by then. About 6 hours later my father called and was safely home in Houston. I could breathe a sigh of relief.

Since then my dad has asked me to look for discount airfares, so he could fly back up here. I guess one bus ride was enough for him. He has also been back up here for a quick weekend trip. One of his friends had to drive to Dallas on business and my dad tagged along with him to see us. So I guess that first trip here for Christmas was not so bad after all. I know I should not have taken his early departure after Christmas so personally. I have been told that once a senior makes up his mind to leave, there's no stopping him. They plow forward...full steam ahead.

If this sounds vaugely familiar or similar to something you are experiencing with someone you love, please allow us to help. Take a look at our webiste at www.hereforyouhomecare.com or call us at 214-389-9401. We offer personal assistance, companion care, homemaking services and respite care at your convenience.

Thank you for reading/listening. Next time I will write about our trip to Houston where we visited my old home, freshly painted and readied for sale and I saw my mother's grave for the first time.

Until then,
Jan

Monday, February 1, 2010

First Christmas without my mother!

The holidays were rapidly approaching and I did not want my dad to be alone. After all, my mother had just passed away in October and he was still grieving. That was the time he needed to be surrounded by loving and caring family members. I had invited him to come back with us several times from our many recent trips to Houston, but he just was not ready yet. This time I was going to put my foot down and arrange for him to be here at least for Christmas. So when all the major airlines started advertising their "special deals", I quickly snapped up a ticket for him to fly up here on December 16th....the last day of the super cheap fares.

Now keep in mind that I had arranged for that flight back in early November when the sales were happening. In the meantime, we had only arrived back from Houston on December 13th, after our whirlwind cleaning out his house extravaganza. I'm not quite sure what my father's idea of emptying a house was, but apparently it was not the same as ours. We painstakingly went through each item in the house and had to make a decision about its disposition. Should we keep it, donate it, recycle it.....take it to my father, save it for posterity? These were all extremely tough decisions, but ones we were forced to make on the spot and without delay.

My dad was not prepared to do this and did not provide us with much guidance. Besides already moving most of his prized possessions, he only told us of a few additional items he wanted. Obviously we disposed of some things that later on my father thought of and wanted. But we did the best we could under the circumstances. I knew that when he first saw his emptied house, he would be upset. But I was not prepared for his incredibly strong and emotional response. To us an empty house meant just that, an empty house. I guess to him it meant shuffling a few things around. So needless to say he was very angry with me after seeing the house on December 14th, 2 days before his scheduled arrival here in Dallas.

Now I know that people tend to take things out on the ones they love. We know that we can treat them badly and they will still love us...still be there when the dust settles. But after the phenomenal time, energy, sweat and tears we spent cleaning out that house, I began growing weary of being blamed instead of thanked. If professionals had emptied the house it would have cost thousands of dollars and everything would have been thrown away. While we did it for free and I saved boxes and boxes and boxes of treasures that I will eventually have time to go through.

So back to the point....my dad's arrival here on December 16th. He was still angry with me and honestly I had grown angry with him....tempered by my empathy with his emotional struggle and grieving. I was prepared to start fresh and avoid discussion of his house. I had reminded him of things to bring well in advance of his trip, but he is not organized and of course waited until the last minute to pack. He brought things he did not need and forgot things he did....more on that later.

Dad had not flown in a few years and was annoyed with all the security measures....removing shoes and belt, but arrived on time and in good shape. We met him inside, helped him with his luggage and whisked him away to our home. Problem #1... he was cold. I cranked the heater up as high as I could stand it. But let's face it.....old people taking blood thinners get cold. And younger people hustling and bustling around cooking and working stay warmer. So I wrapped him in blankets and seated him by the fire.

Chris and I had to work, but we kept him entertained most of the time. We went home to take him lunch and set him up with the TV and his favorite shows for Thursday and Friday. We took him to a party on Thursday night, a progressive dinner and he had a great time. On Friday night we took him to a show he enjoyed. Saturday it was off to the Nasher Sculpture Center (he loves architecture) and the Arts District. That night we went out to dinner with relatives and drove by the beautiful lights out in Plano. Sunday evening our younger daughter arrived home for Christmas, where she too could spend some quality time with Gaggy (their made up name for their grandfather.)

This is starting to drone on a bit.....I better speed things up. My dad went to the Cooper Clinic to have a nutrional evaluation. He turned 88 in January, but plans to live until he is at least 100. He had lunch with some old Dallas friends, had lessons on his new Kindle (a gift from all of us) and spent lots of quality time with us. One of the highlights was a night I found an old letter online that had been written by his great grandmother. I read that to him for about an hour. What a treat for him and me. Problem #2 as well as a lowlight......he failed to bring enough of his medicines. I was able to arrange for a friend of his to pick them up and overnight them to him up here. My take on that....he did it to "punish me" for clearing out his house. I know that sounds crazy, but I have a degree in psychology and that's what I think he did subconsciously.

We had not made definitive plans for his return to Houston. There were several possibilities, but we wanted to "play it by ear." We knew for sure that we would be able to drive him back to Houston on December 31st. Our daughter was flying out of Houston for a school trip and we would be taking her down there then. But I woke up on Christmas morning (after staying up until 3AM finishing baking and wrapping) and said "Good morning and Merry Christmas" only to be greeted by my father saying, "I'm going home tomorrow."

I'll save that lovely story for my next blog. But here's a hint....it upset me and hurt my feelings. But I can take comfort in knowing that I did everything humanly possible to make my father happy and to provide him with a special and non lonely Christmas, his first alone. Please visit our website @www.hereforyouhomecare.com or call our office at 214-389-9401 if your loved one lives in the greater Dallas area and we could provide a compassionate caregiver to support their independence and dignity while staying in the comfort of their own home. Next time....the rest of my father's stay and our return trip to Houston.

To be continued......Jan

Monday, January 4, 2010

"One Man's Trash is Another Man's Treasure"

So D-Day had come...the day when we would begin dismantling my mother and father's home, the house I had grown up in since I was 10. All of the preparations had been made, the dumpster ordered, the car moved, the necessary packing & storing cartons in place. We were ready for the daunting task in front of us...or so we thought. Our kids had arrived from Portland, Oregon on Wednesday afternoon, December 9th. They were "in charge."

Our daughter is an efficiency expert, an industrial engineer by trade along with possessing excellent managerial skills and being able to delegate with great authority. Our son in law is also quite proficient in these areas as well as being strong, hard working and efficient with moving, sorting and loading. Needless to say...they were the team leaders. Now that certainly doesn't mean that they didn't get down and dirty...they did quite a lot of that. In fact they were so smart as to buy cheap white t-shirts that they threw away at the end of each day. We had gloves, masks and other protective equipment to wear. Houses can collect quite a bit of dust, dirt and mold in 47 years.

K&G had a lot of the garage cleaned out by the time we arrived early Thursday afternoon. To say my father is a pack rat would be putting it mildly. We found multiple copies of newspapers dated from when JFK was assasinated, when Nixon resigned and many other historical events. My father had been president of every oranization he ever belonged to....and there were quite a few. Sometimes I think he spent more time running the Rotary or the dance club or the blood board than he did working at his real occupation. So he had saved minutes and notes and an assortment of documents pertaining to all those organizations. What were we to do with all of those? Luckily, K&G had the foresight to rent a truck for all of the hauling expeditions.

Everything possible was taken to the local recycling facility....papers, cans, glass, plastic, cardboard....even aerosols. My father is adamant about recycling, but didn't always have the resources or necessary transportation to make sure his items were transported. So we handled all of his recycling for him. He would be proud and applaud those efforts. One minor problem arose in keeping my father away. Nobody wants to see their precious treasures or memories being thrown away, donated or moved, especially after just losing their beloved wife. So it was easier for us to just make decisions and press on. Since my father isn't driving anymore due to his bad eyes, we were able to accomplish that most of the time. We brought him over a few times and other friends did also, but it just upset him and slowed us down. So we discouraged that.

Now my father kept saying, "One man's trash is another man's treasure." And while that might be true in many instances, it is not always true in my father's circumstance. With his poor vision, he could not see all the "trash" he had accumulated in recent years. A person isn't likely to throw things away if he can't see what they are. He is afraid it might be something important. So in my father's case....one man's trash is another man's trash. We had little direction from my father on what to keep and what to dispose of other than finding and keeping 2 things he wanted for sure. We had already moved the majority of his belongings to his new "digs." If he had given us other directions, they would have been to save everything. Obviously that was not possible. So we moved onward and upward donating and recycling as much as possible.

One lucky break was that the trash was going to be collected the following day. So we were able to dispose of many garbage bags and several very badly worn pieces of furniture that way. We also donated quite a few items and food to the local schools to be used for their classes, education programs and food drive. With a huge orange dumpster in the driveway and people working almost around the clock, neighbors couldn't help but notice us. Many stopped and offered support and kind words about my mother. My parents had been fixtures in the neighborhood for quite some time.

There was a massive amount of "stuff" to be gone through and at times we thought we would never finish, let alone on time. After all K&G had to fly back to Oregon on Sunday afternoon and we had to return to Dallas. I for one was especially skeptical about if we could accomplish our task....meet our goal/deadline. Several other relatives came and helped out for a few hours several days, but far and away the overwhelming majority of the task was accomplished by K&G. Chris and I did our fair share, but nothing close to the 2 chiefs. They even said if another grandma died the next week, they would go clean out her house. That's just what family does....and right they are. So here's to K&G for their unwavering support, help, time, energy and hard work.

So after 4 1/2 long days, one 30 cubic yard dumpster filled, 14 trips to Goodwill (with a huge truck filled with items), 18 trips to recycling and 120 garbage bags filled we achieved our goal...or at least close to it. Our earliest morning starting work was 8:00AM. The latest night was 11:30PM. I brought home hundreds and hundreds of pictures, family documents, heirlooms, furniture and boxes that will take me a year to go through. Some items I will place in albums, some I will give to the other side of my mother's family and some I will save for the next generation. It is not easy to throw away treaures of people you have known and loved. I'll leave that for the future. There were still a few things left in the house.....some that my father would pick up later, some that my father wanted to store for a while, but overall I would say, "Operation Clean Sweep on ______ was accomplished."

Now it was time for the painters and other workers to come in and prepare the house for the next family. They will be making it their home and filling it with their treasures and memories. We will not forget that house or our memories, but it was time to move on. Soon I plan to blog about my father's first Christmas without my mother and how we worked feverishly and tirelessly to keep him entertained, occupied and his mind on happier things. So please visit our website at www.hereforyouhomecare.com again soon. Call our office at 214-389-9401 if we could help your family with caregiving.

Thank you for listening/reading,
Jan