Do Older Adults in Assisted Living Experience More Physical Decline?

By Pamela D. Wilson, The Care Navigator, CSA, CG, MS, BS/BA

Many older adults move from their homes to assisted living communities because they're experiencing challenges remaining at home either physically or cognitively. Many move because adult children have been acting in the role of caregiver and the time required to support care of parents becomes unrealistic. Some older adults are unable to manage medications, others have difficulty grocery shopping and cooking meals and others are simply isolated, lonely and depressed. Do assisted living communities support these individuals in remaining as independent as possible or do they further advance the physical declines experienced by older adult by helping too much because it's quick and easy?

Ignorance: Preventing The High Cost of Re-Hospitalization and Skilled Nursing Stays

By Pamela D. Wilson, The Care Navigator, CSA, CG, MS, BS/BA

According to the Partnership to Fight Chronic Disease, 45% of the United States population is diagnosed with a chronic disease; many individuals diagnosed with multiple chronic diseases. Ever wonder how these costs affect the U.S. healthcare system and the consumer? Individuals diagnosed with chronic disease represent 81% of hospital admissions, take 91% of all prescription drugs and represent 76% of all physician visits. These numbers become more impressive when looking at the cost of Medicare hospital readmissions of $17.4 billion (2004 estimate). The Alliance for Quality Nursing Home Care reports that 17-19% of Medicare beneficiaries are readmitted to the hospital within 30 days and 34% within 90 days.

While the government bears the costs of Medicare, more education is needed for healthcare providers and consumers who also create and bear costs. It’s common knowledge that since health insurance became widely available in the mid-1960’s the true cost of healthcare has been hidden from the consumer because we rarely see the bills. Few consumers ask about the cost of tests or treatments but rather ask about co-pays.

Co-pays should be given more consideration as older adults with multiple chronic diseases find themselves in and out of hospital emergency rooms and skilled nursing communities. The issue – few know or take the time to understand these expenses. Yet it’s exactly these expenses and the related risks to health that force many older adults into nursing homes for the rest of their lives and deplete retirement savings.

State gets tough on referrals for elder care

Seattle Times Newspaper

Originally published Wednesday, April 20, 2011 at 10:00 PM

State gets tough on referrals for the elder care

Washington will become the first state to clamped down the unregulated, explosive growth of elder-care referral businesses that rake in profits, sometimes deceptively, by promising to help families find long-term care for the aged.

By: Michael J. Berens

Seattle Time Staff Reporter

Washington will become the first state to clamped down the unregulated, explosive growth of elder-care referral businesses that rake in profits, sometimes deceptively, by promising to help families find long-term care for the aged.

Dozens of Washington companies offer to guide families through a maze of elder-care options to an adult family home or assisted-living facility that best fits their needs-all for free.

When Was the Last Time You Visited a Nursing Home?

granddad By Pamela D Wilson, The Care Navigator, CSA, MS, BS/BA, CG

Many young people have never visited a nursing home. Yet our parents and grandparents have sickening visions of nursing homes that play in their minds especially when they think about getting older. The nursing environment has changed significantly from the memory our parents and grandparents hold, however the fear of being "put away" remains in their minds. My own mother made us promise never to put her in a nursing home - or she would come back and haunt us. Fortunately my mother passed away never having spent a single day in a nursing home.

The general population is not as fortunate. Few realize that there is no health care system to prevent individuals from ending up in a nursing home. Medicare does not pay for custodial care. Working children are shocked when the medical system does not provide the type of assistance needed when their older parents become ill. An unless you've personally experienced caregiving it's difficult to understand the stress, pressure and sleepless nights experienced by others worrying not only about their loved one but how they will ever financially survive.

Look at the recent economic woes. Most retirement accounts have dwindled to have their previous value. Yet the cost of living remains the same or greater. The cost of one year in a nursing home averages $70,000; one year in assisted living $35,000. If you or your parents had to pay these expenses today would you be able? For the majority of us the answer is no.

So what is the answer? It's not relying on the U.S. healthcare system, a system trying to figure out how to rescue social security, Medicare and Medicaid. The answer is acknowledging the need for and planning for long term care. Long term care insurance is one component.

Older people view long term care insurance as nursing home insurance because in their minds, a nursing home is where one goes when they become old and ill. But the opposite is true. Long term care insurance provides options to avoid nursing home placement.

The majority of individuals over age 65 will require a long term care stay and over forty percent of these individuals will experience a long term care stay lasting two or more years. This can be a long time if you are in a nursing home in a shared room - not private room, with a roommate you dislike. It can be even longer if you are in a nursing home reimbursed by Medicaid versus retirement savings or long term care insurance.

For an individual needing care, a nursing home is generally the last resort. Other preferred options include home care, day care and assisted living. When children become involved in the care of their parents it is usually at an early stage which means that caring for parents can last for years. This is the point where custodial care is most helpful, the type of care not reimbursed by insurance.

This means that working children spend time at work on the phone, arrive late and leave early to take parents to medical and other appointments, reduce working hours, take a leave of absence or resign to move across country to take care of their parents. They spend evenings and weekends at the home of their parents with much frustration because their parents believe their children are the only caregivers that can help. Emotions run high. Children become guilt ridden. Parents expect more and more. And children don't know where to turn.

This reality that will only escalate because of current population estimates, the population is aging, requires a new way of thinking that includes educating employees about issues arising as we age and subsequently educating about the importance of long term care insurance. Many companies fail to have a high degree of participation when long term care insurance is offered without education because employees who have not filled the role of caregiver fail to see the need and the future reality and financial expense of caring for parents and other family members.

Many young people have never visited a nursing home. Yet our parents and grandparents have sickening visions of nursing homes that play in their minds especially when they think about getting older. The nursing environment has changed significantly from the memory our parents and grandparents hold, however the fear of being "put away" remains in their minds. My own mother made us promise never to put her in a nursing home - or she would come back and haunt us. Fortunately my mother passed away never having spent a single day in a nursing home.

The general population is not as fortunate. Few realize that there is no health care system to prevent individuals from ending up in a nursing home. Medicare does not pay for custodial care. Working children are shocked when the medical system does not provide the type of assistance needed when their older parents become ill. An unless you've personally experienced caregiving it's difficult to understand the stress, pressure and sleepless nights experienced by others worrying not only about their loved one but how they will ever financially survive.

When Relationship Difficulties Prevent Care Planning

By Pamela D Wilson, The Care Navigator, CSA, MS, BS/BA, CG

hugging_mom By Pamela D Wilson, The Care Navigator, CSA, MS, BS/BA, CG

Are your parents at the point where the need for help is no longer optional? Have you talked to them about the subject and received a cold shoulder from one or both? Relationship difficulties are often at the root of challenges in accepting or discussing the need for care. These challenges exist not only between parental relationships but between relationships between children and their parents. Caregiving and long term care are subjects many find uncomfortable to discuss. Confronting our own mortality is difficult.

The challenge begins with the relationship between your parents. You lived with them as a child and likely remember which parent made most of the decisions, managed the finances, served as disciplinarian or organized the household. You may recall how well your parents managed or avoided conflict. These challenges do not become easier when parents age, they become more intensified, more prominent. And parents often resist when children suggest that they need help because they are the parent; it's their job to give their children advice, not vice versa. Nor do parents want to be reminded that they are aging and may need help.

When No Family Is Available to Care for a Parent

By Pamela D Wilson, The Care Navigator, CSA, MS, BS/BA, CG

woman_depressed By Pamela D Wilson, The Care Navigator, CSA, MS, BS/BA, CG

A meal site volunteer called to ask my assistance when she received a call from a woman who said she had no food and needed groceries. The volunteer provided a telephone number saying that the woman was at a neighbor's house and did not have her own telephone.

I called Mrs. Smith to ask how we might help, and to confirm she was calling from a neighbor's home. She promptly told me this was her telephone number, that she was at home and relayed her address. I asked if she had friends or family to help her and she replied no. She then went on to tell me that she was very, very hungry and needed groceries. Not knowing the real situation and having to rely on her words, I asked if I could meet with her to see what might be done.

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