Managing Financial, Legal & Insurance Issues

When you’re caring for someone with Alzheimer’s disease, financial, legal, and insurance issues can seem overwhelming and complex. Seeking the advice of a professional and becoming informed about the issues is recommended. This will help you feel confident as you make difficult decisions in your role as Alzheimer’s caregiver.

Financial Issues

An Alzheimer’s disease diagnosis is often accompanied by new financial demands that are required to maintain care both within the home and outside the home. To ensure that enough money will be available to provide continuing care, keep in mind that as the disease progresses, so do the care requirements. Consider evaluating the following:

• Care expenses, both now and in the future, such as doctor visits, prescription medications, home health aide services, and housing (such as assisted living or nursing homes).
• Current sources of income, such as insurance, personal savings, investments, and employee or retirement benefits.
• Other financial resources available through government organizations.

Legal Issues

It’s important to plan ahead and address legal issues as soon as a diagnosis is made. Advance directives are documents that help a person with Alzheimer’s disease state his or her wishes regarding treatment and end–of–life issues. These documents can include:

• Durable power of attorney for healthcare – appoints a person to make all decisions associated with health care.
• Living will – states a person’s preferences on decisions for medical treatment and artificial life support.
• Last Will & Testament – states, among other things, who has been appointed to manage the financial assets and beneficiaries of the person with Alzheimer’s disease.

Insurance Issues

Healthcare insurance can play a key role in helping to ease some of the financial burden of long–term care. Some families have private insurance and it’s important to research coverage and speak to the appropriate company representatives to make sure you understand all the benefits available under the policies.

The most common forms of insurance, provided by the U.S. government, include Medicaid and Medicare.

• Medicaid – Medicaid is a federal program whose eligibility and benefits vary by state. The program is typically administered by a state welfare agency. Medicaid covers all or a portion of nursing home costs. A person with Alzheimer’s disease can qualify to receive long–term care only if he or she has minimal income and cash assets. For more information, visit http://www.cms.hhs.gov/medicaid/.
• Medicare – Medicare is a federal health insurance program for people over age 65 who are receiving Social Security benefits, however, not everyone is eligible. Medicare covers inpatient hospital care and a portion of other medical expenses. Medicare covers some, but not all, of the services a person with Alzheimer’s disease may require. Applications for Medicare may be sent to a local Social Security office. For more information, visit  http://www.medicare.gov.
• Medicare Part D – The Medicare Prescription Drug Program is an optional program. If you elect the Medicare Prescription Drug Program, which is also called Medicare Part D, you can sign up with any one of several health insurance companies that serve your geographical area. In return for a monthly premium, the health insurance company provides you with some or the drugs you are taking are covered. For more information, visit http://www.medicare.gov.

As always, incorporating time for yourself and creating a network of support will be critical in helping you not to feel overwhelmed and alone. Do not forget that you and your loved one are managing this time together, and that both of you deserve the highest level of care and consideration.

Enjoy your week and as always please feel free to reach out to me if you have questions about your particular situation.

Sincerely,

Wendy

Wendy McIlnay is General Manager of Regency On Whidbey. Wendy has over 24 years in the senior living industry and is considered an expert in her field.  Regency is a nationally recognized leader in senior living, providing exceptional care and first-class amenities for its residents.

If you answered yes to two or more questions below then you might be at risk for a fall.

Are you alone several hours of the day or night?

In the past year have you fallen or have been afraid of falling in your own home?

Have you been hospitalized or been to an emergency room in the last year?

Do you have one of the following chronic ailments: heart disease, stroke, COPD, osteoporosis, diabetes or arthritis?

Do you use a cane or walker, wheelchair, stair climber, or other assistive device to help with balance or walking?

Are you required to take several daily medications?

Do you need assistance with one of the following activities: bathing, toiling, dressing, meal preparation or housekeeping?

Falls in the home can occur in bathrooms, bedrooms and on stairs. The following checklist is designed to help anyone who has mobilization issues in the home, whether it be from hip surgery, knee surgery, car accident or has that fall potential. Mobility and fall issues have no boundaries when it comes to age, anyone can fall.

1) Paint the edges of outdoor steps and steps that are especially narrow or are higher of lower than the rest a bright color.

2) Paint outside stairs with a mixture of sand and paint for better traction.

3) Clear snow and ice from entrances and walkways.

4) Inside your home, remove all extraneous clutter.

5) Keep telephone and electrical cords out of pathways.

6) Tack rugs and glue vinyl flooring so they lie flat. Remove or replace rugs or runners that tend to slip or attach nonslip backing.

7) Do not stand on a chair to reach things. Store frequently used objects where you can reach them easily.

Have a lamp or light switch that can easily be reached without getting out of bed.

9) Use night lights in the bedroom, bathroom and hallways.

10) Keep a flashlight handy.

11) Have light switches at both ends of stairs and halls. Install handrails on both sides of stairs.

12) Add grab bars in shower, tub and toilet area.

13) Use nonslip adhesive in shower or tub.

14) Consider sitting on a bench or stool in the shower.

15) Consider using an elevated toilet seat.

16) Use helping devices such as canes or walker as directed by your health care provider.

17) Wear nonslip, low healed shoes or slippers that fit snugly. Avoid walking around in stocking feet.

18) Review medications with your doctor or pharmacist. Some drugs, including over the counter drugs, can make you drowsy, dizzy or unsteady.

19) Discuss safe amounts of alcohol intake with your physician.

20) Have your hearing and eyesight tested. Inner ear problems can affect your balance. Vision problems make it difficult to see potential hazards.

21) Exercise regularity to improve muscle flexibility, strength and balance. Talk to your healthcare professional about exercise programs that are right for you.

22) If you feel dizzy or light-headed, sit down or stay seated until your head clears. Stand up slowly to avoid unsteadiness.

23) Drink plenty of water, dehydration can cause you to become unsteady, cause urinary tract infections and can affect your mental state in turn causing you to fall.

24) Consider asking your health care professional for a prescription for Physical or Occupational services. Regency on Whidbey has its own in-house therapy department which strives to optimize wellness and enhance the lifestyles of seniors on Whidbey Island. (You do not need to be a resident here to take advantage of our therapy department.)

Enjoy your week and be safe!

Wendy

Wendy McIlnay is General Manager of Regency On Whidbey. Wendy has over 24 years in the senior living industry and is considered an expert in her field.  Regency is a nationally recognized leader in senior living, providing exceptional care and first-class amenities for its residents. 

Voted #1 in the 2010 Best of Whidbey for Best Retirement Center-Thank you to everyone for voting for us!

This is a poem that I have had for years. I tried to find out where it originated but was unable to trace it.

Crabby Old Man

What do you see nurses? …What do you see?
What are you thinking……when you’re looking at me?
A crabby old man,…..not very wise,
Uncertain of habit ……..with faraway eyes?

Who dribbles his food…….and makes no reply.
When you say in a loud voice …..’I do wish you’d try!’
Who seems not to notice ….the things that you do.
And forever is losing ………….. A sock or shoe?

Who, resisting or not………..lets you do as you will,
With bathing and feeding … The long day to fill?
Is that what you’re thinking?…….Is that what you see?
Then open your eyes, nurse……you’re not looking at me.

I’ll tell you who I am ……… As I sit here so still,
As I do at your bidding,…….as I eat at your will.
I’m a small child of Ten…….with a father and mother,
Brothers and sisters ………who love one another

A young boy of Sixteen ..with wings on his feet
Dreaming that soon now……….a lover he’ll meet.
A groom soon at Twenty ……..my heart gives a leap.
Remembering, the vows……..that I promised to keep.

At Twenty-Five, now …….. I have young of my own.
Who need me to guide ….And a secure happy home.
A man of Thirty ……….. My young now grown fast,
Bound to each other ……. With ties that should last.

At Forty, my young sons ….have grown and are gone,
But my woman’s beside me…….to see I don’t mourn.
At Fifty, once more, ……… Babies play ’round my knee,
Again, we know children …….. My loved one and me.

Dark days are upon me …… My wife is now dead.
I look at the future …………I shudder with dread.
For my young are all rearing……young of their own.
And I think of the years…… And the love that I’ve known.

I’m now an old man………and nature is cruel.
‘Tis jest to make old age …….look like a fool.
The body, it crumbles……….grace and vigor, depart.
There is now a stone……..where I once had a heart.

But inside this old carcass ….. A young guy still dwells,
And now and again ……..my battered heart swells.
I remember the joys…………..I remember the pain.
And I’m loving and living………….life over again.

I think of the years ..all too few……gone too fast.
And accept the stark fact……..that nothing can last.
So open your eyes, people ………open and see..
Not a crabby old man…..Look closer….see……..ME!!

Remember this poem when you next meet an older perso n who you might brush aside without looking at the young soul within…..we will all, one day, be there, too!

~Wendy

Wendy McIlnay is General Manager of Regency On Whidbey. Wendy has over 24 years in the senior living industry and is considered an expert in her field.  Regency is a nationally recognized leader in senior living, providing exceptional care and first-class amenities for its residents. 

Diet and Nutrition Tips for Seniors with Dementia

Make dining social. Elderly people sometimes  fail to eat well because they don’t like to eat alone.

Take notice of food content in their loved-one’s home. Keep their refrigerator well stocked and watch for and remove old or spoiled food in the fridge. 

Serve finger foods or food that is already cut up. It’s easier for less dexterous hands.

Food portions should be small so they do not look overwhelming. Large volumes of food may spoil an elderly person’s limited appetite.

Monitor your loved-one’s fluid intake. You should make sure they have adequate fluids by keeping a pitcher of a favorite drink in the refrigerator and serving from that source.

If your loved one has a decreased appetite you can:

Offer high caloric drink foods such as ice cream, milk shakes, or eggnog.

Offer familiar foods; these favorite foods can stimulate the appetite.

Try making the main meal of the day at lunch when the appetite is often larger.

Sit directly in front of the person and show each spoonful to help them orient.

Offer 4 to 6 small meals a day instead of 3 larger ones. 

If your loved one is having problems swallowing:

Allow time between bites and check mouth periodically for food in the cheek.

You may need to remind the person to swallow.

Gently stroking the throat will help to stimulate swallowing.

Observe and alter food textures that cause the most difficulty. Liquids can be thickened with gelatin or applesauce. Solids can be moistened or pureed for easier swallowing.

Have your loved ones teeth or dentures checked at least once every 6 months. Seniors often fail to eat because their dentures no longer fit properly.

If your loved one is having motivational problems

Make the meal look appetizing on their plate. You can accent their plate with a fruit or vegetable garnish, coconut flakes or melon. 

Make the dining experience pleasant for the person you are caring for. Playing soft music, lighting candles or talking to them about the day’s events while they are eating will take their minds off not feeling well.

Family Support Systems

Communicate about the status of your loved one with your family and friends. If people close to you understand what is going on they can give you more help and support. 

Bring the children to visit, unless your loved one specifically asks you not to. Visits help keep relationships whole and maintain a sense of attachment and continuity for your loved one. 
Try to share the responsibility of meal time with other members of your family. You can have a potluck where each person brings something and you can enjoy family time together.

Sincerely,

Wendy

Wendy McIlnay is General Manager of Regency On Whidbey. Wendy has over 24 years in the senior living industry and is considered an expert in her field.  Regency is a nationally recognized leader in senior living, providing exceptional care and first-class amenities for its residents. 

Do you have a question about the senior in your life? Feel free to email Wendy at manager@regencywhidbey.com

www.regencywhidbey.com       

Everyone is aware that there are different stages in the progression of an illness and that the person living with that illness will go through a range of emotions.  However, we rarely reflect that caregivers, too, go through different stages of development, emotion and need while performing their role.  Caregiving is an act of love, but it is also a demanding and challenging job. 

I have taken care of seniors for over 24 years.  In addition, I am also the  primary caregiver for my elderly mother so I am  aware of the challenges facing caregivers, and I’d like to share my experiences with you.

Caring for someone with Alzheimer’s or dementia in particular is associated with a higher level of stress than caring for someone with functional impairment from another type of illness.  One survey on caregivers revealed that persons with Alzheimer’s disease required an average of 70 hours of care per week, with 62 of those hours provided by the primary caregiver.

Since caregivers have a tendency to focus so much attention on their “job,” they often overlook their own personal needs, telling themselves that their needs pale in comparison with those of their family member or loved one who is ill. 

Just as the caregiver wants to keep his or her loved one as fit, healthy, strong and emotionally well-balanced as possible, it is even more important for caregivers to treat themselves with the same level of care to stay healthy and effective.  Taking care of yourself is one of the best things you can do for your loved ones, and it will enable you to keep giving the very best care.

Here are some simple things to keep in mind if you’re a primary caregiver:

Make sure to make time for yourself and your own daily routine.

• Schedule regular afternoons or evenings out.  If you can’t get away and friends or other family members cannot come over, take time each day for a phone call with a friend.  Having a support network can be invaluable.
• Think of diversifying roles and people in your network as well.  Find a reliable teenager in the neighborhood, or a handyman service, to assist with household chores, home repair or maintenance.  In addition to the emotional support offered by friends and co-workers, you can take them up on offers to drive, cook, pick up prescriptions or assist in other ways.
• Join a support group to connect with people who understand the challenges you are facing and can share your experience.  Not only is it reassuring to hear and learn from others in similar situations, but you may also find solutions for practical problems as well.  Day-to-day frustrations such as managing insurance claims or finding the best pharmacy can seem mundane, but they require a lot of time and energy.  Practical advice from someone who has already navigated the waters can reduce stress and save time. 

It is important to remember that you are not alone.

Staying connected with friends, family and members of a support group – or finding service providers to assist you – will go a long way to helping you provide care for yourself and your loved one. 

Respite care provides caregivers with a needed rest.

One of the best ways for a caregiver to obtain a needed rest is to arrange a short-term stay for his or her loved one in a safe, caring and nurturing environment.  At  Regency On Whidbey, staff ask a lot of questions before residents begin their stay at a community – from medication and sleeping preferences to favorite foods and hobbies.  By knowing the answers to these questions, the respite care provider can plan out appropriate services and care for each individual.  In this way, a community like Regency can assure you that you are placing your loved one in good hands.

There are some things, however, you’ll have to do for yourself. 

• Make sure you get enough sleep, even if it means taking a short nap during the day. 
• Make daily exercise a part of your routine.  A walk around the neighborhood not only gives you the benefit of cardiovascular exercise, but also gives you time to reflect and recharge.
• Be sure to eat nutritious meals, and be wary of giving in to stress-induced urges to overindulge with food or alcohol.
• Find some time to relax each day. 
• Also, don’t forget to pamper yourself when you can: Plan a spa day, a weekend-getaway or a short vacation. 

Being mindful of your own needs and feelings is extremely important.  Caregivers are at increased risk of depression and other symptoms of distress.  A recent study in the Journal of the American Medical Association shows that seniors providing care for an ailing spouse are likely to become sick more often and experience more stress than seniors who aren’t caregivers. 

 Symptoms of depression that should not be ignored include: 

• Persistent feelings of extreme sadness or hopelessness.
• Constant anxiety, irritability or anger.
• Persistent feelings of detachment, numbness or exhaustion.
• Negligence or hatred of caregiving responsibilities.

It’s understandable to feel depressed, anxious or overwhelmed while you are providing care.  Everyone experiences some degree of increased stress, and those feelings can increase over time.  Because of this, it is extremely important that you remain attentive to your emotional well-being and obtain help when you need it.

Incorporating time for yourself and creating a network of support so that you are not alone in your responsibilities will help you avoid feeling overwhelmed and allow you to provide the best care possible.  Do not forget that you and your loved one are managing this time together, and that both of you deserve the highest level of care and consideration.

 Sincerely,

Wendy McIlnay

 Wendy McIlnay is General Manager of Regency On Whidbey. Wendy has over 24 years in the senior living industry and is considered an expert in her field.  Regency is a nationally recognized leader in senior living, providing exceptional care and first-class amenities for its residents.