How to Help

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A Brainstorm of Ways You Can Help Your Loved One at Home

· Regular Visitation
· Regular Phone Calls· Grocery Shopping
· Food Preparation
· Help with household chores
· Assist with mail/bills as needed
· Take out trash/recyclables, empty wastebaskets
· Water plants
· Mow the lawn, rake leaves, shovel snow
· Weed the garden
· Drop off/Pick up dry cleaning
· Fix small appliances/Handyman services
· Take the car for an oil change/gas/inspection
· Polish the silver
· Fill the birdfeeder (or provide one if there isn’t one!)
· Transportation to doctor’s appointments/social events/etc
· Cards/Notes from Children/Grandchildren
· Videotape Recorder w/videos of family, local & out of town
· Make computer literate for email, internet, games, correspondence
· Board Games
· Puzzles
· Organize a card or scrabble game w/friends
· Books & Books On Tape
· Create a music cassette of favorite/meaningful music
· Tape a church service if unable to attend and bring it home
· Send an audio letter if you live faraway
· Clip interesting articles from papers/magazines
· Organize family photos- create albums/collages/personalized calendars
· Create a scrapbook of memories “This is Your Life” and celebrate.
· Find any reason to celebrate something like “Happy Thursday!”
· Help write “The Book of My Life” for future generations
· Drop off magazines/periodicals/circulars of interest
· Take dictation of notes/letters and mail them
· Schedule your visit to watch a sporting event or video together
· Bring children to visit
· Bring pets to visit
· Call now and then with neighborhood gossip
· Take for a ride in the car
· Visit a zoo, park, mall, movie – wheelchairs are often provided
· Give a gift certificate for a manicure, facial, massage
· Give a gift certificate for long distance calling
· Create a coupon book as a gift with blanks for the fill-in of things you may not have considered
· Create a tradition of visiting at the same time each week to give something to look forward to
· Organize a social or church group to adopt seniors as secret pals and send cards, gifts, remembrances
· At gift-giving times, forgo the gifts and send a train/plane ticket to someone who wouldn’t normally be able to visit
· Set up a fish aquarium/bird cage and maintain
· Prepare a window garden
· Contact a local columnist to recognize the person for a special life achievement
· Help decorate for the holidays
· Create a visitation schedule/calendar so others know where the visitation gaps will be and plan accordingly (this is also a reminder how involved family and friends actually are)

· Have medical information handy so that visitors know what to do in case of emergency.

· Communicate with other family/friends/visitors when there is a need to be filled that comes up within the context of your visit.

· Stay alert, work together, support one another as a team would work together for the good of their mission. Help one another as needs arise so that you can continue giving to the issue(s) at hand.

· Take care of yourself.

Time to Laugh: Letter To Safe Harbour Middle School

This will warm your heart............... 
Just when you have lost faith in human kindness...

Someone who teaches at a Middle School in Safe Harbor, Florida forwarded the following letter.The letter was sent to the principal's office after the school had sponsored a luncheon for the elderly. An old lady received a new radio at the lunch as a door prize and was writing to say thank you.

"Dear Safe Harbor Middle School:

God bless you for the beautiful radio I won at your recent senior citizen's luncheon.
I am 84 years old and live at the Safe Harbor Assisted Home for the Aged. All of my family has passed away. I am all alone now, and it's nice to know that someone is thinking of me. God bless you for your kindness to an old forgotten lady. My roommate is 95 and always had her own radio, but before I received one, she would never let me listen to hers, even when she was napping. The other day her radio fell off the nightstand and broke into a lot of pieces. It was awful, and she was in tears. She asked if she could listen to mine, and I told her to kiss my ass. Thank you for giving me that opportunity.

Sincerely,
Edna Walters"

Old Age is Like a Bank Account

I Have Heard This Story Told Over and Over. Working in Admissions over the years, it becomes quite inspiring to think of this man. 

'A 92-year-old, petite, well-poised and proud man, who is fully dressed each morning by eight o'clock, with his hair fashionably coifed and shaved perfectly, even though he is legally blind, moved to a nursing home today. His wife of 70 years recently passed away, making the move necessary. After many hours of waiting patiently in the lobby of the nursing home, he smiled sweetly when told his room was ready.

As he maneuvered his walker to the elevator, I provided a visual
description of his tiny room, including the eyelet sheets that had been hung on his window.

"I love it," he stated with the enthusiasm of an eight-year-old having just been presented with a new puppy.

"Mr. Jones, you haven't seen the room; just wait."

"That doesn't have anything to do with it," he replied.

"Happiness is something you decide on ahead of time. Whether I like my room or not doesn't depend on how the furniture is arranged .. it's how I arrange my mind. I already decided to love it. "It's a decision I make every morning when I wake up. I have a choice; I can spend the day in bed recounting the difficulty I have with the parts of my body that no longer work, or get out of bed and be thankful for the ones that do. Each day is a gift, and as long as my eyes open, I'll focus on the new day and all the happy memories I've stored away. Just for this time in my life.

Old age is like a bank account. You withdraw from what you've put in.
So, my advice to you would be to deposit a lot of happiness in the bank account of memories! Thank you for your part in filling my Memory bank. I am still depositing."

Remember the five simple rules to be happy:
1. Free your heart from hatred.
2 . Free your mind from worries.
3. Live simply. Trust God.
4. Give more.
5. Expect less.'

~ Author Unknown

How To Choose a Nursing Home

There have been a number of incidents publicized lately regarding specific issues of deficiency and neglect in local nursing homes. How do you find a "good" nursing home? Here are some tips to get you started:

1) The New York State Department of Health offers a good list of questions. However, since New York is a highly-regulated state, many of these questions will have the same answers from nursing home to nursing home. Fortunately the baseline for acceptable care is much higher than in other parts of the country.

2) Don't simply take someone's word for it. You wouldn't purchase a home without seeing it first. Don't go to a nursing home without touring it first and asking questions. Supplement your questions with good observations. Pay attention to how clean the facility is; how well-groomed the residents are. Listen and observe how the staff treats the residents. What is your gut feeling? Would you entrust these people to care for your friend or relative? Is the atmosphere the right chemistry to offer a sense of personal security and comfort?

3) Talk to a number of actual residents and their families. This is their home and they should be able to give you an honest assessment and most would appreciate the opportunity to do so.

4) Review the recent Department of Health survey results which will indicate any deficiencies and plans of correction. The results must be made available to any visitor of any facility and will provide you a good indicator of the facility's weak areas.

5) Learn which nursing homes have specialized programs. The "best" facility may not be the best for you if you have Alzheimer's Disease and they don't provide such specialized care. Some nursing homes are strong in Rehabilitation, for example, or Dementia or Respiratory Care and some are strong in providing good old-fashioned long term care to those who don't require specialized services.

6) Finding the right nursing home can be a very emotional process. Try to have faith that going to a nursing home doesn't necessarily need to be the "end of the road". There have been countless people who, as nursing home residents, have learned skills, made friends and developed talents they never knew they had. It can be a growth experience for all if treated as an opportunity rather than as an obstacle.

7) Keep in mind that no matter what the track record is for a particular nursing home, there is someone who would never go back and there is someone who would never go anywhere else.

8) Try to plan ahead. Most people don't begin to explore nursing homes until they are in crisis, when it is impossible to make a clear decision. If you are in crisis, meet with a geriatric care manager or other professional who has firsthand experience and knowledge of each and every nursing home.

9) You may not be ready to put nursing homes on your list of things to familiarize yourself with, but make the most of an opportunity to do so. If you have a relative or friend in a nursing home, go visit them. It will be good for them and in the long run will be good for you, for any number of reasons!

Good times at the Home

Managed Care Forces Growth

By Kate McGahan CSW

The absence of a national health policy seems to have created a black hole that has been filled with profit driven managed-care programs. While states such as California have been adapting to the managed-care concept for a number of years, New York is just beginning to feel the effects. Syracuse is a good example of community agencies working together to rise to the changes in demographics and in the industry.

The cost of running Medicare and Medicaid programs has been growing at nine percent per year. Experts say that, by the year 2030, Social Security, Medicare and Federal pensioner programs will exceed the federal government's revenues. The seemingly insurmountable task of trimming the budget seems to have come down to trimming the payments to the care providers. Massive state and federal cutbacks have severely affected hospital and health programs and the way they do business.

What does this mean to us? The managed care shift has had the tendency to refocus the healthcare industry toward business development and marketing efforts rather than customer service and patient care. The game has become "SURVIVAL". In the hierarchy of needs, physicians, hospitals, home care agencies, and other programs which rely on insurance to keep them alive have had to find a way to put food on their proverbial tables. This is a challenging task and makes it difficult to meet the more advanced qualitative needs of perfecting patient care.

Aggressive insurance procedures now affect providers on a multitude of levels. Insurance companies reward hospitals for treating patients with higher clinical needs. Medicare pays a certain rate for the treatment of a specific illness and the insurance companies follow suit. The more severe the illness, the higher the reimbursement. They also can refuse to pay for days a patient spends in the hospital on which a significant intervention did not take place. Subsequently, providers now find they need to perform surgery and diagnostic testing on weekends and after hours to promote reimbursement. This means paying additional staff for hard-to-fill time slots. It also includes paying additional staff to process the multitude of paperwork required for patient billing and reimbursement.

The "system" encourages the prompt discharge of less acute patients and begins a ripple effect that forces all parts of the healthcare delivery system to push a patient quickly toward the least restrictive, most cost-effective setting. This ripple effect causes nursing homes, rehab centers, home care agencies and others to need to be available off-hours and on weekends to do intake assessments, admissions, and crisis intervention. This new system presents an arena of discharge planning and case management considerations.

Because nursing home and rehab facilities are reimbursed for patients with higher needs, they also are eager to discharge residents who are more able to manage in a less-restrictive setting. People who one would have been permanent residents in nursing homes are now being encouraged to return home with services or to go to assisted living programs and special care facilities. The system has been forced to be creatively revised in the face of these new regulations. New residential and home care programs have arisen to compensate for the greater number of nursing home and hospital discharges. Some skilled facilities have developed subacute and short term rehabilitative services to capitalize on higher reimbursement levels. More and more independent living programs are offering a concierge of services.

Alzheimer's Disease is tragically one of the lowest reimbursable illnesses. It is one of the most common, of the longest duration, the most time consuming, and exhibits some of the most frequent repeated use of services in the system. The system does not financially reward providers for caring for people with such disorders.

How we cling to the status quo! Peter G. Peterson, in his book Gray Dawn, gives us a reality check: By 2015, most developed countries will have more elders as a share of their population than the state of Florida today. Caring successfully for older adults in the face of managed care will take a community-wide effort. The population is aging and managed care is here to stay.

Healthcare providers need to develop a positive attitude despite the lack of perfection in the system. This means making a shift from a sickness mentality to a wellness mentality; to prevention vs. cure. It's about having vision and defining a contributing role within a system that thrives on networking. It's about being proactive rather than being swept along with the tide of managed care; to begin to create and enhance programs, products and services and to become leaders in a system specialty.

Many US hospitals are forming partnerships with residential and rehab programs, home-care agencies, and primary care providers. Residential facilities are developing day programs and menus of services to expand their markets. Doctors are joining forces to meet the comprehensive needs of their patients.

There are many ways to partner - formally and informally- to meet the needs within the senior healthcare system. Formal alliances allow partners to share operating costs and collectively to meet the needs of the community. Clinical, financial, social, private, and public programs need to be available, accessible, and mutually beneficial to the older population. We need to learn how best to utilize one another to support the needs of those who need us.

Learn to see this as a challenge rather than as a problem. Exciting innovations are already occurring within the Central New York system. Follow the leaders of the community in developing unique programs to offset the negative consequences of managed care.

Loretto and St. Joseph's Hospital have partnered to meet specific needs which make programs like PACE/Independent Living Services- a program designed to prevent/reduce institutionalization and subsequent costs possible. Crouse Hospital and Community General Hospital together created The Alliance, which proposes to merge with VNA Systems to streamline the continuum of care for their patients. SUNY Health Science Center recently announced participation in WebMD - a full-service Web site for doctors and their patients --made possible by the combined efforts and funding or organizations such as DuPont, Microsoft, and CNN.

Competition is a driving force of the new system. Once we re-establish our equilibrium, we can allow competition to do what it does best: improve quality, reduce costs, and encourage providers to be creative in the marketing and delivery of their services. We must also work collectively to keep the continuum of care smooth and as user-friendly as possible.

The possibilities are endless. Growth doesn't just "happen" without people making a conscious change. If we don't promote change on our own, life will inevitably do it for us. It has pushed us to grow in challenging, sometimes frustrating and very exciting ways.

Try to be ProActive Not Reactive

http://hulubei.net/tudor/photography/photos

Be Proactive, Not Reactive in Caring for Aging Parents
By Kate McGahan LMSW

We don’t like to think about aging and the potential issues of death, disability, dependence and cognitive loss. Because we don’t like to think about these things, we tend not to plan ahead for the inevitable.

Yes, the “system” has it’s own frailties. The “system”, however, is making dramatic strides to try to improve service delivery while at the same time, to reduce the tremendous costs of running federal and state programs such as Medicare and Medicaid.

The Managed Care system is changing health care delivery by attempting to reduce and eliminate unnecessary costs and treatments of medical health care. While far from perfect, this has in part caused a dramatic shift in the care and lengths of stay in hospitals, rehabilitation facilities, and nursing homes. Hospital stays have shortened, rehabilitation while nursing home facilities are now meeting more acute care needs of their residents. The newer residential concept of “Assisted Living” is now meeting the needs of many people who normally would have required nursing home care. Home care programs have been recharged to meet increasing needs of those who wish to remain at home.

Granted, there are many weaknesses in the system. Therefore, we need to be accountable for planning for our own future and the future of our aging families. Never underestimate the power of the “private pay dollar” when it comes to buying what you need and want in the health care system. That “dollar” buys your choice of caregivers, physicians, residential options and other preferred services.

How do you maximize the private pay dollar? By starting as early as you can to plan for your retirement. By saving and investing your money wisely. By maximizing your retirement income and pension plan. Have a solid health insurance plan that best supplements Medicare and a Long Term Care(LTC) Insurance plan that will fill the remaining “gap” of financing your long term care needs in the future.

Find out about medically-deductible expenses which can include the costs of nursing home care, home care, medications, home improvements due to a disability, insurance payments, copayments and a portion of your LTC insurance premium. You may qualify for a dependent-care credit if you are caring for a dependent parent at home and if you contribute to your parent’s medical expenses, those expenses may be deductible if you itemize.

Investigate the possibility of creative options such as a Reverse Mortgage or a HUD conversion loan which allow you to use the equity in your home to fund the costs of your long term care. Open a Medical Savings Account (implemented in 1996 on a demonstration basis) which allows you to invest your money and then reap your earnings tax free if applied to your personal health expenses. Look at your life insurance portfolio; you may want to borrow from your insurance to pay for your current needs.

Respectfully encourage your parents to plan for the future, if they haven’t already done so. Think about and implement Advance Directives such as a Living Will or Health Care Proxy. Establish a Power of Attorney and a legal and financial plan to attend to future needs.

Involve a team of objective, competent professionals to help you design a plan that is best-suited to your situation and personal goals. The ideal team will consist of an attorney, a financial adviser, an accountant, an insurance specialist and a geriatric care manager. The involvement of this team will help you in making sound decisions in the areas of financial, tax, estate planning and personal long term care planning.

Many Baby Boomers will find that they will spend more years caring for their aging parents than they did raising their children. Some will find themselves in the overwhelming situation of caring for both at the same time! Only 5-7% of our elderly population resides in nursing homes. The others are being cared for by families, home care agencies and informal caregivers. Many more are living active, independent lifestyles.

Gather your team of advisers, save and invest your money wisely and learn what choices are available to you. Communicate with your family and create a healthy lifestyle for yourself. When you have the support of those who love you and the advantage of good physical, emotional and financial health, you will find yourself surrounded with unlimited choices as you face the days ahead.

Counting Our Blessings

Many of us get preoccupied with the things we have lost over the years. How important it is to also remember the things we still possess. This is the text from an email attachment I received that reminds us how fortunate we are:

If you woke up this morning with more health than illness, you are more blessed than the million who will not survive this week.

If you have never experienced the danger of battle, the loneliness of imprisonment, the agony of torture, or the pangs of starvation, you are ahead of 500 million people in the world.

If you can attend a church meeting without fear of harassment, arrest, torture, or death, you are more blessed than three billion people in the world.

If you have food in the refrigerator, clothes on your back, a roof overhead and a place to sleep, you are richer than 75% of this world.

If you have money in the bank, in your wallet, and spare change in a dish someplace, you are among the top 8% of the worlds wealthy.

If your parents are still alive and still married, you are very rare, even in the United States.

If you hold up your head with a smile on your face and are truly thankful, you are blessed because the majority can, but most do not.

If you can hold someone’s hand, hug or even touch them on the shoulder, you are blessed because you can offer healing touch.

If you can read this message, you just received a double blessing and you are more blessed than over 2 billion people in the world who cannot read at all.

Be sure to count your blessings as Spring arrives!

As we count our blessings, we thank the friends of Elderplanning who offer their ongoing support, confidence and assistance in helping those who need us to find us! The strength of our service is in the strength of the vast network of professionals and agencies in our health care community. We appreciate your referrals and your help in meeting the ever-changing long term needs of our local seniors and their families.