More than 15 million Americans provide unpaid care valued at $210 billion for persons with Alzheimer’s and other dementias, according to the Alzheimer’s Association’s 2012 Facts and Figures Report.

A recent study conducted by Working Mother Research, sponsored by GE and with input from the Alzheimer’s Association, revealed that 82% of current Alzheimer’s caregivers are keeping aging family members at home or in the patient’s home and that 49% report feeling stressed and 36% feel depressed.  As part of their work, the National Association of Professional Geriatric Care Managers shared these study results and provided an overview of how geriatric care managers can assist families in caregiving and planning.

Family caregivers face a lot of worries over a loved one with dementia.  A Harris interactive poll conducted in the fall of 2010 reported caregivers’ top concerns included their loved ones’ memory loss, personal safety and confusion.  Sixty percent of the caregivers surveyed felt overwhelmed.

If your family is facing dementia, using a professional consultant such as a geriatric care manager can save you a lot of time, money and stress.  Here are just a few things a geriatric care manager can do for you:

• Help you get a good diagnostic work up and get linked with good care providers; initial planning and consultation as well as counseling as you face a new diagnosis
• Consult with your family on specific issues such as finding appropriate resources and making family decisions about care
• Mediate family disagreements and help to overcome behavioral concerns that often accompany dementia such as paranoia or refusing care
• Assist in setting up Alzheimer’s specialty home care or finding an appropriate assisted care facility
• Elder care management: oversight for families at a distance, help managing medical appointments and coordinating care
• Crisis intervention to step in during an emergency room visit or sudden change
• Help navigating through tough issues like giving up driving, deciding to move a loved one in with you or to a care facility and advance care planning

For families facing dementia, we recommend the following steps:

1. Get a thorough diagnostic workup and locate specialists in your area.  You may benefit from a neurologist and geriatric psychiatrist and a specialty memory clinic can be a great resource for specialized care and treatment.  Confused by the terminology of dementia, Alzheimer’s, and age-related memory loss?  Get a copy of our Memory Loss Info. Sheet.
2. Get involved with your loved one’s care.  You may need to find a balance in respect for your loved one’s privacy and wishes, but you will need to become more involved to ensure coordination and safety in the long term.  Interestingly, the Harris Poll noted above reflected the value of this involvement, with 53% of caregivers who were not involved in healthcare discussions with providers being dissatisfied with care, as opposed to 31% of those who were involved.
3. Make a visit to your attorney, or get a referral to an elder law attorney.  A qualified attorney can review your current documents and make recommendations so that you are prepared.
4. Study up, with information from reputable sources.  You might want to check out some of our recommended reading for dementia caregivers under our “resources” section as well as visit The Alzheimer’s Association website.  It is also helpful to begin determining what resources are available in your area so that you have adequate time to make decisions.

A professional care manager can help with all of the steps above as well as offering you customized recommendations that best fit your family’s needs.  As you think about hiring a geriatric care manager, you might want to download our free checklist with questions to ask and thing to consider:

Contact us at 727-447-5845 or online for more information or to schedule a geriatric care management consultation for your family.

Health News Florida recently published an article on Florida Hospitals’ readmissions rates based on the up-to-date numbers that have come out on Medicare’s Hospital Compare website.  The news for Florida is quite mixed, as the only state with two “A+” hospitals and two failing hospitals.

Readmissions rates are under heavy scrutiny from Medicare and other entities.  There has been a lot of discussion around the problem of readmissions and possible solutions.  A number of hospitals across the country have been involved in pilot programs to investigate solutions and resources for seniors and their families.

As this article points out, there are fairly complex issues behind the rates.  For example, the “back and forth” that exists for patients who reside in an assisted living facility or nursing home, where the decision to return to the hospital may be made by staff when it could possibly be avoided.  Then, there is also the balance between readmissions rates and mortality rates…raising the question, do we sacrifice safety over readmitting someone?  And, readmissions vary greatly by condition as certain conditions are more difficult to control outside of the hospital environment and tend to have complications (though the readmissions rates are compared by different conditions).

The focus on readmissions rates will soon affect hospitals’ bottom lines, as Medicare begins penalizing hospitals with higher than average rates starting October 1st.  As mentioned, this is a complex issue and hospitals face real challenges overcoming the multiple factors that play in to these rates.

However, one underlying factor in this discussion is coordinated care.  One of our most popular blog posts covers the issue of coordinated care for elders, including some of the challenges and solutions for elders and their families.  Family and professional patient advocates can play a role in ensuring better coordination of care despite potential systematic gaps/problems.  By asking the right questions, providing the right information and coordinating follow up closely, patients can experience better outcomes on an individual level.

Here are a few of our tips for you to ensure better coordinated care and improve health outcomes for yourself or a loved one:

1. Know the questions to ask and anticipate possible concerns/needs.  How to do this if you’re not an expert?  Grab a copy of our Dicharge Checklist to start and become a vigilant record keeper.
2. Hire a patient advocate.  This will help you take #1 to the next level, using the knowledge of an expert in the system so you know things like typical concerns for this condition/patient’s situation and resources and creative solutions for after-care.  A professional patient advocate also knows how to navigate the system, who to talk to about concerns and how to get answers.  You can bring in a patient advocate for a crisis/one-time need or hire one to coordinate care long-term which is especially beneficial for individuals with chronic illnesses.
3. Get to know your medical providers.  As a family advocate, attend appointments with your loved one, find out who are the key contacts in the office/system and seek out key personnel during a hospital stay (nurse, attending physician, discharge planner/social worker) so they know you are involved, and explain the background, situation and concerns.

While hospitals continue to focus on improving their readmissions rates, it is vital for caregivers to take an active role in the care planning process.  Your participation helps providers to provide more continuity and have a more holistic view of the patient.

Need help navigating your medical care?  Want advice on the best options for Florida home health care after a hospital stay or rehabilitation options?

Or, give us a call any time at 727-447-5845 or toll free 888-807-2551.  We’re here to help with solutions when you need them!

A recent article, Why health tech startups should care about ‘alpha geek’ caregivers outlines the role technology is playing for today’s elder caregivers. As the article notes, a Pew study concluded that caregivers were more likely than other internet users to search online for health information and use social health tools.  In other words, caregivers may be on the forefront of the online health information movement (i.e. “alpha geeks”).  Here are a few of the statistics from the study:

• 38 percent of online caregivers have looked at drug reviews online, compared with 18 percent of non-caregivers
• 26 percent of caregivers online have searched the Web for someone with similar health concerns, compared with 15 percent of non-caregivers
• 21 percent of online caregivers have looked at online reviews and rankings of doctors or other providers, compared with 13 percent of non-caregivers
• 24 percent of online caregivers said they tracked health indicators (other than weight/fitness) and symptoms online, compared to 13 percent of non-caregivers

In our experience, caregivers are particularly motivated to use online tools…tools that can really help in elder care management–saving time, stress, money, and solving a real-life concern.  As with all technology, there are multitudes of apps and sites available and only the ones that are worth the effort to solve a real concern will be worthwhile.  Caregivers are stretched between multiple responsibilities and need to know any efforts and costs will return greater benefits.

Finding quality information online is an obvious priority to caregivers based on the statistics above.  Aging Wisely has tried to play a significant role in this area for elder caregivers by providing educational materials and answering questions and concerns we most frequently hear.  You might want to check out our eldercare handouts available right on our home page and senior care links (see “resources”) and keep an eye out for our blog articles reviewing useful websites and tools.

In the past, we have provided some advice on eldercare technology tools and personal health records online.  Aging Wisely uses a tool called Caregivers Touch for elder care management of our clients.  Some of the benefits to such tools include increased efficiency, improved continuity of care and streamlined communication.

What are some types of tools and resources you might find most useful in caregiving?

• Legitimate online reviews and ratings such as Medicare’s facility compare-for hospitals, nursing homes and home health companies and states’ licensing websites such as Florida’s Facility Locator.  Client ratings and reviews can also be helpful along with comments from other caregivers, though it is important to look at data as well and consider that your circumstances may be different.  An elder care professional can help you understand how ratings and data are determined and understand the background of referral sites and organizations.
• Tools that facilitate communication, allowing you to access your loved one’s information easily (there is a lot to keep track of in managing elder care) and to share information with relevant parties.  Any tool that can help alert family and friends of updates can save you a lot of phone time that you can focus on other tasks.  These range from programs with apps focused on organizing and storing information such as Caregivers Touch to online communities like Caring Bridge and Lotsa Helping Hands.

As part of our care consultations and geriatric care management assessments, our care managers can recommend a variety of technologies to improve elder care management and your loved one’s safety.  Our care managers research tools ranging from personal emergency response systems to medication dispensers and share data with you on facility ratings and success rates.  To talk to our Community Liaison about how a consultation or assessment could help you, call us at 727-447-5845 or click below to request a time:

Want to get the latest eldercare resources and links?  You can get notified by email of our blog updates (once-twice week).  Just enter your email address at the top right of this page.  We welcome your comments!

Almost all seniors desire to remain in their own homes as they age, a concept which is often referred to as “aging in place”.  As a son or daughter, you may have concerns about your aging parent’s safety at home.  How can you help ensure an aging parent’s home safety?  What preparations can be done to allow aging in place?  What red flags should you watch for to indicate safety concerns?

If you are feeling a bit uneasy about your elderly parent’s safety or are disagreeing about such issues with other family members, you may want to start by checking out Aging Wisely’s Senior Safety Warning Signs.

Here are a few of our tips on how you can enhance senior home safety as well as a great checklist for aging parents you can download:

• Do a physical home safety review or have a professional assessment.  Safety issues include removing clutter and fall hazards, ensuring proper lighting, modifying the home or adding assistive devices to ease activities of daily living and more general home safety such as fire safety and storage of hazardous materials.
• Determine a system for “keeping an eye on things” such as family member visits and talking to loved ones on the phone.  No one wants to feel intruded upon or a lack of privacy, but for yours and your loved one’s peace of mind it is vital to have support and oversight in the least obtrusive manner possible.
• Consider getting a personal emergency response system.  These “call buttons” made famous by the “I’ve fallen and I can’t get up” commercials help ensure assistance can get to the elder if anything happens.  The technology is becoming more sophisticated and some systems offer GPS support or fall detection (in case a senior falls but cannot push the button).  There are affordable options for these systems and your local hospital or Area Agency on Aging may offer discounted systems as well.

The aging population, the boomer generation, longer life expectancies, more chronic illness…all add up to a greater role for elderly care management in the lives of today’s families. 

The Bureau of Labor Statistics gathers data on Americans’ time use (how they spent the last 24 hours) and they added eldercare activities to the questions in 2011 so we now have some up-to-date numbers on unpaid elderly care activities.  Here are some of the statistics revealed in that survey:

• 39.8 million people were providing unpaid care to someone over age 65 due to a condition related to aging.
• 56% of those caregivers were women (a lower percentage than in many past studies, indicating more men being involved in this role).
• 23% of elderly care givers were parents of 1 or more children under 18 in their household.
• The majority of care recipients lived in a separate household from the elder caregiver.
• About 30% provided care to more than 1 person.

We all have anecdotal evidence of the pervasiveness of caregiving amongst ourselves and family and friends, but this survey confirms the solid role that elder care management is having in Americans’ lives.  It also reveals some of the complexities that caregivers face, such as also caring for children, managing elder care for more than one person and living away from care recipients.  We recently covered a number of these issues (and tips to help) in our article about the “sandwich generation”.

The extent that elderly care management has reached in to our day-to-day lives with longer life expectancies and more chronic illness has pretty far reaching implications.  First, it is a positive reminder that families do provide a lot of care and support for loved ones, when sometimes there is a tendency to say we don’t do that “like we did in the good old days”.  Of course, as the study indicates, the circumstances may be different, with more care being provided while living separately and more people working and caring for children while also managing elder care.  We also know that elder caregiving can have big impacts on caregivers, not only emotionally, but also financially in real and opportunity costs.  Caregivers often help assist with elderly parents’ costs or give up job opportunities or extra work to be available for elder care needs.

At Aging Wisely, we work with many families who are doing their best to provide great elderly care management for those they love.  We see their struggles and understand both the personal nature of the journey as well as the common challenges.

We’d love to hear from you about some of the challenges you have faced as a caregiver and how we can help or what information you would find most useful.

We have developed two primary resource centers for quick references for caregivers, in addition to our blog and social media channels.  Check out the handouts at our Eldercare Resource Center on a wide array of topics and our Floida Senior Care links page under our “Resources” section.

Need help today?  Call us toll free at 888-807-2551!

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You have most likely heard the term “sandwich generation” and may in fact be living this feeling of being sandwiched between the multiple needs of your beloved younger and older loved ones.  Here’s the Wikipedia break down on what this term means and the scope, in case it’s a bit unfamiliar:

“The Sandwich generation is a generation of people who care for their aging parents while supporting their own children.

According to the Pew Research Center, just over 1 of every 8 Americans aged 40 to 60 is both raising a child and caring for a parent, in addition to between 7 to 10 million adults caring for their aging parents from a long distance. US Census Bureau statistics indicate that the number of older Americans aged 65 or older will double by the year 2030, to over 70 million.”

If you’re living this, we probably don’t need to tell you the special challenges of caring for your children (even helping adult children) and caring for aging parents (or a disabled spouse or other relative).  Elder care management becomes all the more challenging when you are balancing multiple responsibilities and likely feeling guilt that you might not be doing enough, either for your elder or your children.

An added challenge for many families we help at Aging Wisely is the distance factor.  Many adult children who call us about elder care management concerns live at some distance from their elderly parents here in Florida and are attempting to make travel arrangements, make tough decisions about when to come/when to step in, deciding whether it would be better if an elder parent moved closer (or in with them) and trying to coordinate medical care via phone.  Some family members are even doing this from overseas, living as expats or working abroad (or traveling often for work) as covered so eloquently in the blog Adventures in Expat Land.

Here are a few of our tips for sandwich generation caregivers trying to manage multiple responsibilities of elder care management, taking care of children, work and more!

• Use tools that can save you time and headaches (i.e. “get organized”) such as putting together an online health record for your elder loved one who you assist.  Have a quick list of contacts and important numbers and information handy.  Do a little proactive research on some local resources (especially if you are at a distance).  Technology can really be your friend in being organized and more easily having access to information (though this can also be overwhelming).
• Plan visits well, if you are a long-distance caregiver.  Allow enough time for “family time” and don’t overload yourself (and your elder loved one) with tasks.  Check out EasyLiving’s great “long distance caregiver checklist for visits” to help you organize.
• Be up front with your kids about what is going on with your elder parents (as appropriate to their ages) and how you need to assist.  Set some expectations and involve them.
• Don’t see bringing in help as a sign of weakness or reason for guilt.  You are doing your best to help your aging parents, raise a family and manage all that life throws your way.  Sometimes the best thing you can do is to bring in professional advice or help in certain areas.  Though elder care is a very personal issue, like many areas of life, you may be best served by seeking out expert help.  A good starting point is a geriatric care management consultation.

“Sandwiched” caregiver looking for some advice and resources?  Long-distance elder caregiver trying to manage and oversee care, ensuring your loved one’s well-being from afar?  Give us a call to talk over your concerns and questions, schedule a consultation or find out more about how we can help with Florida eldercare resources and management.

727-447-5845 or toll free 888-807-2551 or contact us online to plan a time to talk

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How do we find good care?

How can we approach our stepmom about our worries?

We think it’s time Mom moved to Assisted Living.

My sister and I don’t see eye to eye on how to proceed.

We have a lot of lists but no advice on what might be best.

There are a lot of sensitive issues within families surrounding eldercare.  The first question that arises for most families is when to seek out help or when to take action.  The issues are so personal that you may feel reluctant to seek out professional help or advice.

If you are facing these questions, you might want to start by taking a look at our “Warning Signs” handout, which provides some important questions to ask and things to watch for that might indicate it is time to seek outside assistance.

One of the best ways to get started when you have some concerns is to consult with a geriatric care management professional.  This is something you can typically do before deciding it is time to make a commitment to ongoing services and can even be done by phone if you are long-distance. 

Here are some benefits to family caregivers that might help you ascertain if a care consultation would help you:

• The care manager can be a sounding board for you about how you are feeling, your concerns, what next steps might be wise, and options, especially if all family members are not “on the same page”.
• You can get some immediate advice on tasks you may want to start working on, preparations you can do in advance and places to go for help should a crisis arise.
• The consultation provides you the opportunity to meet a local elder care professional who you can call upon to help now or in the future.  It can be a huge relief if a crisis or concern arises to have a trusted professional that you already know who you can call.
• The consultation often reveals aspects of the situation you might not have considered or things that can save you a lot of future headaches–it’s this “insider’s scoop” that can be so valuable in deciding on the right steps to take.  It can often relieve your anxieties about whether or not you are doing the right thing and help your family start out on the same page.

If you want to talk to someone one-on-one about whether your situation warrants a consultation, call us at 727-447-5845 or contact us online about Aging Wisely consultations.  We can also provide you with referrals to elder care professionals in various areas of the country.

Why is dementia care particularly challenging?

Caregivers can share many stories to illustrate the various challenges a family faces.  The process is a little different for everyone.  The disease of Alzheimer’s (as well as other forms of dementia) is especially heartbreaking because of the memory loss and related behavioral changes affecting those diagnosed.  Our personalities and intellect are at the heart of our identities.  To experience and adapt to these changes can be emotionally draining.

The essence of these changes is what makes dementia care so specifically challenging.  There are a lot of safety concerns that arise, and caregivers walk a fine line between independence and safety.  At some point, as complex thinking is compromised, a caregiver must step in to make certain decisions and take over certain processes.  This can be emotional and may be met with a lot of resistance from the person you are trying to help.

Just a few of the more challenging issues that dementia caregivers may face include:

• Driving safety
• Living alone, managing a household, managing personal care
• Paranoia, fear of caregivers
• Wandering
• Sundowners Syndrome and restlessness
• Refusals of care (refusals/arguing over bathing, changing clothes, etc.)
• Eating/nutrition issues (not eating, forgetting one has eaten and eating too much, inability to prepare meals or safely manage food)
• Agitation, anger, personality changes

Sundowners Syndrome and wandering are two potentially intense challenges for many Alzheimer’s caregivers, and they often go hand-in-hand.  Sundowning refers to behaviors that take place around late afternoon and evening, including restlessness, agitation and increased confusion.  Wandering may be a big component of this, especially as many with Sundowners Syndrome feel a sense of “needing to go home” or restlessness about something that needs to be done.

Where can you find support and answers if you are dealing with Alzheimer’s caregiving, especially the challenges of Sundowning, wandering and other behaviors?

• Join a support group or online group/forum of caregivers in like situations (explore support groups in your area to find out which groups you can identify with–people in your age group, relationship to the person, and stage of caregiving–though a mix of experiences can be helpful too).  Contact your local Alzheimer’s Association or Area Agency on Aging for support group listings.
• Get a copy of EasyLiving’s new “Caregiver’s Guide to Dementia Care” eBook (free!), with specific tips and strategies on managing behaviors and caregiver resources.
• Still confused about the terminology and signs of Alzheimer’s versus dementia, Sundowners Syndrome and normal memory loss?  Grab our Dementia Fact Sheet.
• There is a lot of great information available online, but be sure to talk with your doctor about any medication or alternative treatments you are considering.
• Talk with family members and friends about how they can support you.  Even if you do not feel comfortable leaving your loved one in the care of others, they can assist with tasks and errands.
• Set up an Aging Wisely caregiver consultation.  During this consultation, we find out about your situation and offer specific expert tips and resources to address your top concerns.  You might also benefit from a geriatric care management assessment if you are struggling with figuring out what to do next.  A geriatric care assessment provides specific care recommendations, budget projections and resources to assist with care and helps you to plan for future issues and considerations.
• If you bring in outside care assistance, make sure the professional home caregivers are trained in Alzheimer’s specialty care.  Ask what in-house training the home care agency provides and how they oversee care and assist their caregivers to manage challenging behaviors and provide specialty care to your loved one.  Qualified, professional caregivers can help ease your caregiver stress and provide respite for you.

When you are helping with the elder care management of a loved one, you serve as their advocate.  This role is a significant and important one, whether you are providing support or serving as the decision maker for a family member who is no longer able to do so.

What are some of the typical challenges families face in coordinating medical care?

• Understanding privacy laws and legal provisions for decision making and assisting a loved one.  This is particularly challenging because providers may have different understandings of laws and families often get conflicting information.  Additionally, providers and facilities may have specific policies and forms with which you need to comply.  (Grab a copy of our “Getting Answers about a Loved One’s Care” for an overview and tips.)
• Navigating insurance, benefits and procedures.  Consumers have often complained about a lack of transparency in healthcare and insurance policies, making it difficult for the average person to get clear information.  This is improving as information becomes available online and there is a push to provide consumers better information, but it can still be a lot to figure out (especially when dealing with the emotions of an ill loved one and balancing many tasks).
• The practical and emotional difficulties of trying to help someone with very personal (and vital) decisions (or even make them as a substitute decision maker).  Individuals often have very different feelings about medical care and end of life wishes, which may even vary greatly over time.  This is a particular challenge for family members who have not discussed such issues, where conflicts exist and where major decisions have to be made in high-pressure circumstances.

Thing you can do to help someone manage your medical care (or things you can begin to explore with older loved ones you will help):

• Make sure you’ve made preparations for decision-making.  Key documents that need to be prepared include: a durable power of attorney, medical power of attorney/healthcare surrogate, and a living will.  A qualified estate planning or elder law attorney can help you understand what documents are needed and prepare them according to your personal situation.  Also, find out what paperwork your medical providers need (most have a privacy statement on which you can indicate persons to whom they can release information).
• Talk about it!  Try to start an open dialog about beliefs, concerns, quality of life and what you would want in regards to your care.  You can’t cover every possible scenario, but discussing these issues can give your loved ones a better idea of your personal beliefs and help them if they need to make decisions on your behalf.
• Put together a medical file.  This makes things easier on you or caregivers who help (think about having information handy whenever you have to fill out new patient paperwork, and having easy access to provide good background during an emergency).  Put together a notebook or use an online system with your: diagnoses, medical history (diagnoses, surgeries, family history, etc.), medications, allergies, and medical providers’ contact information.
• Contact a professional patient advocate. Some of the situations in which an advocate might help include: working through family conflicts or dialogging about decisions, providing an assessment and organizing your medical history, referring to needed professional services or helping locate specialists/programs, navigating Medicare and insurance, and assistance in the advocacy process/overseeing care.

Contact us at 727-447-5845 with questions or click below to: