I have always been a big fan of Howard Gleckman, author of Caring for Our Parents.  In fact, he was the very first person I interviewed for my Leaders in Elder Care series.  If you aren’t familiar with Howard’s blog, you’re really missing out on a complete play-by-play of how the health care debate is impacting the cost of senior care.

This morning, he shared some startling statistics about paying for elder care that I have quoted below.  In this article, Howard has links to some fascinating studies about the out-of-pocket costs for seniors, and it is shocking.  It is mind-boggling to me how financing elder care will be solved as we move forward. He wrote:

A typical couple would have to save nearly $200,000 to pay for their out-of-pocket medical costs from the time they are 65 until they die, according to an important new study by the Center for Retirement Research at Boston College. Add in nursing home costs, and they are likely to need $260,000.

But that’s only part of the story. About 5 percent of 65-year-old couples will face catastrophic medical and long-term care costs exceeding $570,000, according to researchers Anthony Webb and Natalia Zhivan.They estimate those expenses would have exhausted the total financial assets of 85 percent of all retirees even at the peak of the stock market in 2007.

As someone who has first-hand experience with out-of-pocket expenses and my Mother’s care, I was still so stunned by these numbers, that I could not write a conclusion to this article.  What do you say?

Obviously, I encourage you to check out Howard’s writing.  In the meantime, what are your thoughts about these big numbers?

Photo: bubble dumpster

Early-onset Alzheimer’s disease is one of 38 degenerative conditions included in the Social Security Administration’s new Compassionate Allowances program.  This fast-tracking system is designed to aid younger patients and their families in moving quickly from diagnosis to benefits.  Expediting this process aids in reducing stress associated with waiting for the lengthy approval process, and trying to plan the next stages of life while in a state of limbo.  Many of these younger patients–most in their 30s and 40s–are still working and have more extensive financial responsibilities than the traditional Alzheimer’s patient.  More typical Alzheimer’s patients are in their mid-to-late 60s, retired, and also too young to be receiving Social Security retirement benefits in some cases.

Effective March 1, 2010, the Administration will be able to electronically target and make prompt decisions in the best interest of the disabled patients.  In the past, when a younger patient began experiencing the cognitive limitations, they were not traditionally tested for Alzheimer’s disease. Instead, they were thought to be suffering from job and life-related stress.  This issue added to the lengthy process of identifying the correct diagnosis and than being approved for disability benefits.  With this new program, it is estimated that tens of thousands of younger Alzheimer’s sufferers will now qualify in a matter of days rather than the traditional months or years it often took in the past.

According to the Administration, approximately 200,000 people under the age of 65 currently suffer from the symptoms of early-onset Alzheimer’s disease.  Due to the sheer volume of potential benefit applicants, the Administration will also benefit from this new program as it will reduce the time and effort of the appeals process that in the past would contribute to slowing down the system for every patient.

Photo: benprks

In aging seniors, healthy brain function is about more than just memory and coordination; everyday tasks, relationships, hobbies and quality of life are all affected.  It stands to reason that the more aware and capable you are of cognitive reasoning and performing independent living activities the higher your self confidence and emotional health.

The nation’s largest study on brain fitness was performed in 2002 by the Advanced Cognitive Training for Independent and Vital Elderly (ACTIVE) and their results showed that a large percentage of participants over the age of 65 improved memory, reasoning and information-processing speed when they participated in training for five days per week.  In addition, the study showed a 47% lower risk of dementia in participants who worked crossword puzzles four days a week than those who only worked the puzzles once a week.  These results play into the notion of “Use it or Lose it” when it comes to cognitive aging.

Furthermore, an Australian study consisting of 30 peer-reviewed papers in controlled trials found that, as people experienced these lifestyle benefits they were also able to live longer and therefore reduce health care expenses.

Along with these studies, it is widely known that many seniors regularly engage in crossword puzzles, Sudoku and similar brain training games to slow dementia and aging.  Many software companies have tapped into this need by creating games and exercises that aid in sustaining mental acuity.  It has been reported that the brain fitness software market grew from $225 Million in 2007 to $265 Million in 2008.  Here are the top three systems that claim to reduce dementia rates in seniors.

Posit Science

Posit Science claims that their products will help the user “think faster, focus better, and remember more.”  Their software programs are designed for either a PC or a Mac. Each priced at $395.00

1. Brain Fitness Program: Six programs that allow you to “Remember more & Feel Sharper” by practicing matching items, distinguishing objects, memory recall and story telling.
2. InSight: Five programs designed for “Better Focus & Learn More” focusing on visual precision.
3. DriveSharp: Two programs that deal with divided attention and increased processing times so that you will “Drive Carefully & React Faster”

Dakim BrainFitness

Dakim offers two brain training concepts for seniors.

1. A complete self-contained console that only needs a high-speed internet connection but does not require a keyboard, mouse or software program installation.  It is marketed to both the individual senior and the senior living provider.  After the initial purchase of $2,299 for the touch-screen console, more than 150 games are available for a $19.95 per month subscription.
2. 2. New brain fitness software to be released this April for $349.99, which includes a one-year subscription.

CogniFit

CogniFit is a web-based system that does not require you to install software or purchase a console.  Instead you access the programs through their website.  Both programs described below are priced based on the following subscription terms: $19.95 per month, $99.50 for 6 months, or $170 annually.

1. CogniFit Personal Coach:  This program addresses overall cognitive skills and claims to improve memory and focus, and increase processing time.
2. CogniFit Senior Driver: Similar to other driving programs, this system is designed to improve reaction time, handle multiple driving tasks and focus on potential road threat recognition.

About the Author: Ryan Malone is the founder and managing editor of Inside Elder Care and the author of the By Families, For Families Guide to Assisted Living.  He can be reach on Twitter at @RyanMalone.

It is important to remember that when caring for an adult parent that you also care for yourself as well.  Any form of elder care can be draining on an emotional, physical and time commitment level.  In order to be able to sustain your generous efforts, you need to seek out and be able to ask for assistance.  You will want a network of people and agencies you can rely on for consistent support, when you need a respite or in the event of an elder care crisis.

As you begin to develop the support team as described below, remember that the key to success lies in the ability to ask for help.  Even if other family members live farther away, still enlist their assistance and together you will come up with ways they can best support you.

Steps for Developing Your Support Network

1. Make a list of each person who may be available to you such as family, friends, neighbors, members of your community groups and churches. For each person take note of the following:
2. Phone number for easy reference
3. What they are available and willing to provide in the form of help
4. What days and times they can offer to you
   1. Check with your local Area Agency on Aging for respite and other assistance.
   2. Create a list of your regular responsibilities both in the role as caregiver and your personal duties to yourself and your immediate family.  Don’t forget to include activities such as picking up your children from school or practice or helping with other errands.
   3. Next to each task estimate the duration of time (including commute) so that you can provide a realistic time commitment to your network and you do not feel the stress of rushing around.
   4. Begin asking your network in what areas they would be most able to support you.  Because your list is detailed and specific it will be easier to get positive responses for these individual needs.

It really helps in sharing some of the responsibility if you make this list easily accessible to other members of your family so that if need be, they can make phone calls in case a change or crisis should arise.  Remember that just because you took the initiative to create the network system does not mean you have to manage it alone.

Other Resources

In order to help you create, complete and maintain a thorough and organized support system, I have developed easy-to-use worksheets in the workbook of The By Families, For Families Guide to Assisted Living Workbook.  While the book is written for assisted living, the worksheets are applicable to all levels of care.

photo: BrittneyBush

A couple weeks ago I had the pleasure of traveling to Oregon to speak at three assisted living communities across the state.  I posted some pictures of the event on the Inside Elder Care Facebook page at http://www.facebook.com/eldercare.  Brookdale brought me up from California to visit three communities—all from distinct areas within Oregon.  They were:

• Albany – small towns set in an agricultural area just southeast of Portland
• McMinnville – right in the center of Oregon wine country
• Gresham – at the base of Mount Hood (yes, I was cold)

At each community, I gave a talk entitled Assisted Living Saved My Mom—a presentation communities ask me to give that provides an insider’s view about how to determine which assisted living community is best for your family.  Assisted Living Saved My Mom shares many techniques that uncover information you would never get from just speaking to an admissions director.  Brookdale provided a copy of my book to each who attended—something appreciated by the attendees.  Based on the large amount of feedback I received from attending families and people in the industry, the message really hit home and benefited many people.

Despite the obvious differences in the locations of each of these communities, I found a few things in common:

• Warm and friendly: nearly every person I met—from the staff to the residents—were very welcoming and warm.
• Pride: there is a strong sense of pride in the residents that carried over to their feeling that it was their responsibility to make new residents comfortable.
• Camaraderie: I got the feeling that the residents genuinely enjoyed each other’s company. You could tell because they all knew each other’s little quirks and habits—something they found amusing.

One thing that came up repeatedly was the concern over “How do I pay for this stuff?” Many people were surprised there were other payment options beside just selling their house and paying cash.

When I wrote the By Families, For Families Guide to Assisted Living, I interviewed nearly 200 families to ask them about the concerns related to assisted living and elder care.  The issue of paying for elder care came up as a primary concern from almost three-quarters of those families.

The financial issues are the elephant in the room.  Most people don’t know how to solve them or even where to start, because there is no holistic guide for families on how to navigate these issues.  I am a month or two away from releasing my second book that gets into these answers—the feedback from those that have seen it has been really positive.  Stay tuned.

As a blogger, most people will tell you, “stay on message.  Don’t deviate, or you’ll lose readers.”  They are right.  On rare occassion it is justified, however.  That occasion is today.

I received an email today from Gladys Broxton, the executive director at Regency Park Oak Knoll in Pasadena.  Gladys was one of the first people who brought me in to give my “Assisted Living Saved My Mom” talk.  She is also an enromously compassionate woman who runs a wonderul assisted living.  Great staff.  Long tenure.  All the things you look for when you evaluate assisted living communities.

At Inside Elder Care, we’ve always spoken about the very difficult job that caregivers undertake.  Many times it is thankless.  All of the time, it is very tough work.  In this light and with Glady’s permission, I am reposting the email she sent me below.  Help if you can.  And if you can’t — think some good thoughts.

–

Dear Friends, Family, Staff and Colleagues:

I come to you with a heavy heart requesting for your financial support to help one of my staff members who is in great need of financial assistance for burial.

Rosario Rodriquez has been working for me 6 years as an exceptional caregiver.   She is a young, kind, and caring individual who works extremely hard to provide the best care for my residents.  She and her husband, Eduardo has been married for only 2 years.  Her husband is gravely ill with liver cancer.  His battle with this rare cancer is almost over.  Rosario and her husband have no life insurance and no medical insurance.  Her husband was being treated at USC because he was part of a research project.  However, he is losing his battle, and doctors are telling them that they can’t do anymore to help him.  This burden is insurmountable and I am amazed by Rosario’s strength and love for her husband.

At this point her husband has no more strength left.  The cancer has caused his skin to leak fluids, the doctors have now put him on hospice, and Rosario is faced with the obvious and inevitable circumstance of him passing.

I come to you all asking for you’re help by donating any amount that comes from your heart.  I hope to collect enough to at least ease the financial burden for Rosario in some way. She is not aware that I’m asking for donation’s she has so much pride I admire her so much for her strength, love and faith for the past two years.

Please keep her and her husband in your prayers.  If you can help, please contact me as soon as possible

Sincerely yours,

GLADYS BROXTON
EXECUTIVE DIRECTOR
REGENCY PARK OAK KNOLL
255 SO OAK KNOLL
PASADENA CA 91101
626-578-1551

What is the definition of “home”?  Well, in most dictionaries home is where you live at a particular time, a dwelling, an environment offering affection, safety and security, a haven.  But it also goes beyond the confines of four walls and a roof over our heads.  Home is also used in a broader sense relating to or being where one lives or where one’s roots are; as in “my home town,” a place where something began and flourished and even possibly the country or state or city where you live.  So when we talk about Aging-in-Place, eventually we need to also address the importance and impacts of the built environments beyond our houses.  We need to evaluate if our neighborhoods and communities will enable successful aging and livability; You see, “our homes” contribute to the basis of our individual and common identities. They hold our memories and they give us a sense of place.

The year 2011 is seen by many as the beginning of the “Changing Face of Aging” in America.  It is when the first wave of baby boomers (those born between 1946 and 1964) will start to turn 65; that is less than 2 years from now! How well will our communities as they are currently configured deal with this paradigm shift based on age? Their ability to adapt to the changing needs of an aging nation should factor into every planning decision that the community is considering.  How projects, developments and urban planning might impact older active adults can no longer be an afterthought if our communities are to retain their appeal and remain not only habitable but also profitable in every meaning of the word.

AARP has done extensive research on the baby boomers in recent years and has found that “Boomers” are:

• More ethnically diverse than prior generations.
• Tend to be more highly educated than prior generations.
• Do not plan to retire  in the traditional sense.
• Plan to continue to work during their “retirement years.”
• Live in the same State…a state of denial!
• Wanting to remain in their own homes as they age or as long as possible.

In fact when asked where they want to live as they age, 90 percent of Boomers say, “in my home.”  They do not want to live with relatives, in a nursing home, or at an assisted care facility. They want to live at home independently and without loss of comfort, security and the freedom to continue to engage in community life.

But given the nature and configuration of most communities across the United States, can Boomers realize those expectations?

Unfortunately most of the country, if not the world, is likely to find itself unprepared for the coming tidal wave of Boomers known as the Silver Tsunami. As we look ahead, we find that the 65+ population is projected to grow faster than the population at-large in all 50 states, with some states finding themselves in the challenging situation of having more Medicare-eligible seniors than school-age children. It is expected too that this population will double over the next 30 years, to over 70 million; a third of America’s current population!

As you can imagine, these age-based population changes will come with many challenges including how to make our communities more “livable.”

Often people, local governments and even States don’t think about this until they suddenly find themselves trapped in towns with poor public transportation and not enough medical services. Simple services like grocery or drug stores, may become too hard to reach without the help of a neighbor or friend – especially as seniors give up their driver’s licenses for safety reasons.  Even walking, if there are no sidewalks, become a major challenge. Without addressing some of these basics we risk ending up with an aging population prone to isolation, social disconnect and despair.

What are Livable Communities?

In AARP’s study, A Report to the Nation on Livable Communities: Creating Environments for Successful Aging, livable communities are defined as those with “affordable and appropriate housing, supportive community features and services, and adequate mobility options, which together facilitate personal independence and the engagement of residents in civic and social life.”

Livability under those parameters means asking questions such as, does your home town have one-story dwellings? Or are most homes built to accommodate the raising of families? Is there a Visit-ability initiative in place that encourages or insists on no-step entries, sidewalks you can actually walk on, bus stops with benches and overhead shading or shelters, libraries and parks that are easily if not even universally accessible and much more.  Most communities these days find themselves blindsided by the changing needs based on aging and playing catch up or even in some cases don’t even realize what’s hit or about to hit them until it’s too late!

We’re all responsible, as individuals, members of local government, city planners, or simply as voters to think about these issues in the days to come so that we can not only safeguard ourselves but also to increase our chances to age well in the future by making the right decisions now.

Livability is not just an aging and elderly issue.  Striving and insisting on nothing short of livable communities is not an impossible goal and in fact in many ways is the right thing to do to continue to empower people as they age and to prolong their quality of life. Such communities make life more comfortable and convenient for active and able citizens regardless of age as well as those with disabilities.

Yet in order to meet theses most obvious of things we will need a wholesale overhaul in the way we think about our homes and our built environments. After all, embracing the principles of livable communities honors those core foundations of American life: dignity, equality, independence, and the freedom and right to choose….and we will need to start doing so now!

About the Author: Raad Ghantous is the principal of Raad Ghantous & Associates and is an expert in luxury hospitality, wellness centers, and medical & day spa developments.  He is also the owner of Your Home For A Lifetime, an A.D.A/ Barrier-free/ Universal design/Aging in place, full service design/build firm with over 15 years of experience  specializing in developing integrating elegant and seamless designs/modifications to new or existing structures

Happy New Year everyone!  I hope everyone had a great holiday and is excited for a fun and positive 2010.

Just a quick note to let you know that I will be presenting “Assisted Living Saved My Mom” at Brookdale Senior Living in Irvine, California.  Irvine is in the middle of Orange County, about 35 minutes south of Los Angeles.

A Unique Presentation

Designed for families and industry professionals, “Assisted Living Saved My Mom” is a unique and interactive presentation that shares how families can make a positive experience out of assisted living.  I share  tips for families that you will not hear in other places and can only be said because my family lived it.  In fact, there are a few parts that make the assisted living provider a bit uncomfortable.  Why? Because you’ll learn the tough questions to ask!

Peace of Mind

You’ll leave this presentation confident in your ability to (a) decide whether assisted living is right for your family, and (b) if it is, how you can take the bull by the horns and make it a good thing.

Brookdale will be providing at no cost autographed copies of my book series “The By Families, For Families Guide to Assisted Living” to all who attend.

Here’s the info – I really hope to see you there:

Wednesday, January 13th @ 6pm
Brookdale – Inn at the Park
10 Marquette
Irvine, CA
(located across from the UC Irvine Campus)

(949) 854-3766

For RSVPs, please email Beth Otterbein – botterbein@brookdaleliving.com

Growth in the senior population is creating an increasingly large market for senior care and products that help seniors age more gracefully.  With high-growth markets, it is common for people and companies to appear with less than stellar ethical standards.  Unfortunately, ethics is one of the elephants in the room when it comes to senior care.

In this Leaders in Eldercare interview, I had the pleasure to speak with Eve Stern, co-founder and co-CEO of SNAPforSeniors.  In this discuss, we take on the issue of ethics, discussing the pros, cons and gaps in elder care today.   I think you’ll enjoy the conversation and the leadership by example Eve has employed at SNAP.

About Eve. M. Stern, RN, MS, Co-CEO, SNAPforSeniors, Inc.

Eve M. Stern is Co-CEO & Founder of SNAPforSeniors, a data and technology company that develops and distributes the most current and comprehensive senior housing and home health resource information in the U.S. She has more than 30 years of line and staff experience in healthcare business development, product development, operations and marketing. Her past accomplishments include building several successful technology and online healthcare product and service companies. Prior to SNAPforSeniors, Eve was senior vice president of business development and marketing for NexCura, an online communications and decision support tools company for consumers with chronic illnesses which sold to Thomson Healthcare in 2005. Eve was responsible for building national strategic distribution alliances with over 50 major e-health sites including the leading non-profit advocacy and commercial organizations. She was also founder and CEO of EthoSolutions, the first online job matching service for healthcare, later selling to J. Walter Thompson. She holds a Master’s degree in Health Science Administration from SUNY Stony Brook and a Bachelor’s degree in Nursing from Columbia University. Eve has published multiple articles on informed decision making, online consumer empowerment and is a frequent speaker at national industry meetings.

About SNAPforSeniors, Inc.

SNAPforSeniors is a Seattle-based data and technology company that collects, aggregates and standardizes data from public/private authenticated sources for senior service providers, augments it with direct data submission and provides a common database for use by trusted third party organizations.

Contact Information

www.snapforseniors.com

“How long does it take for a caregiver to help my mom or dad?”

This is a question I am frequently asked when I speak at assisted living communities.  Most communities offer some form of help button, usually in the form of a pendant or wristband worn by the resident.  When mom or dad needs help, they press the button.  A signal is sent to front desk where a receptionist or nurse dispatches assistance to the room.

Going back to my question, most community marketing staff will respond that help comes within 5 to 15 minutes.  But how do you verify this?  And what do you do if mom or dad says they ring the buzzer and nobody comes for an extended period of time?  What is your loved one has a poor perception of time?  Is there a way to monitor the situation without being annoying to everyone?

Finally… A Solution

The system is called Lifeline and it is made by Philips.  If you don’t remember, there used to be a commercial for Lifeline.  It showed an elder woman who fell. She presses a buzzer and says “I’ve fallen, and I can’t get up!”  I used to think that this system was only useful in the event of an emergency, but boy was I wrong.  Lifeline rocks!

I recommend every resident in assisted living get Lifeline for a variety of reasons, including:

• Vocal system: Your loved one gets to request assistance from a real person rather than a pendant.  The fact is, even with a pendant, you never know if they message was received and how it is interpreted.  Configured correctly, you can have the Lifeline people call the assisted living front desk and ask for help.  And they keep calling until the reach someone.  That’s what they are there for.  Your mom or dad benefits from acknowledgment of their need and the ability to community to the urgency – something helpful to the community as well.
• Third-party verification: Every time your loved one calls Lifeline, they track everything that happens.  Each action is stamped with a date and time.  From the second the button is pressed until the reset button is pressed, you have access to an objective party’s view of what happened.  The case is not closed until someone in your loved one’s room presses the reset button and/or your loved validates that they have been helped via a phone call.
• Audit trail: A more detailed report is sent to your Lifeline sales rep that indicates example to whom your loved one spoke, who at the assisted living was contacted and when the reset button was pressed. In the event something doesn’t go as your service plan provides, you’ll know exactly who did (or didn’t) do what.
• Passive: The system gathers this information without being intrusive into the daily life of your loved one.
• Friendly, caring people: The people at Lifeline are really helpful and genuinely concerned.  I have gotten several calls from them personally when the community front desk is not responsive or does not react with urgency when they make a request on the behalf of my mother.  My mother loves them, because they always call back to check and make sure she has been helped.

How it Works

Lifeline connects to a standard telephone line.  They offer the device and several more advanced phones that include the Lifeline device integrated with a telephone.  My mom has the cordless phone version.  Your loved one is provided a pendant they can wear around their next or wrist.  The cost is around $35 per month with a $25 activation fee.

When the button is pressed, the Lifeline device calls Lifeline’s call center.  The device is placed into speaker phone mode so your loved one can make a request without being close to the phone.  The speaker phone has an extra-sensitive microphone in the event your loved one is in the bathroom or far from the phone.

The vast majority of the time, your loved one will respond and make a normal request.  In this case, the device will automatically call Lifeline back in 30 minutes if the device has not been reset (i.e a caregiver presses the reset button).  For the 1% of the time something is medically wrong, 911 is called.

Setting it Up

Lifeline allows you to set up your account with a number of notifiers.  These are people that need to be notified every time there is a call.  Our account is set up to call the assisted living front desk first.  This ensures a caregiver is routed to my mom’s room.  In parallel, a fax is delivered to me that indicates the following:

• When the call was made
• What the request was about
• When Lifeline was reset

My Lifeline sales rep is awesome (if you live in SoCal and want her name, email me).  She receives detailed reports of exactly what happened on each call.  This is great for trying to understand if there was a gap in care, delayed response or caregivers who were not accomodating.  She forwards them all to me.  I keep the ones that look out of the ordinary in the event a pattern emerges.   To be fair, the vast majority of the time, the caregivers are prompt, friendly and do a great job.

Benefit to Us

Lifeline has provided an extra degree of peace of mind for my family.  The community knows I have the device, so they know there is a objective monitor measuring response times. My mom knows something is tracking everything.  If she loses track of time, she is much more likely to ask me how long something took than to be upset if it seemed like it took a long time.  By skimming the reports, I have the peace of mind that mom is doing well, getting out of the house, going to activities, etc.

If you click on this image, you can see a sample actual report.  The names have been scrubbed to protect their privacy.

I can’t recommend this enough. And I recommend you also use the pendant, because they Lifeline only works in your room.  For around $35 a month, it such a stress-reliever.