Could the key to a long life be in these little devices?

Knowledge is power, but action is necessary to put that knowledge to use. We know the keys to a long life from research on the world’s longest-living populations. Meanwhile, modern life is pulling us further away from these healthy habits. Fortunately, a modern solution may also help us truly take action towards living a long life.

Wearables are seen by many as a great possibility for building healthy habits into our daily lives. A wearable device incorporates technology into something you wear such as clothing or an accessory (think Apple Watch, Fitbit or Google glass). They always make me think of James Bond!

A PWC study found that consumers see great potential with widespread use of wearable health technologies for long life and better health:

• 56% believe life expectancy will grow by 10 years because of wearables
• 46% believe they will decrease obesity

And, the potential for these devices being integrated into a healthy, long life is amazing! Cisco estimates the number of wearable devices in use will jump to almost 177 million by 2018.

The advantage of wearable health technologies is the ability to get real-time data that we can use to change behaviors and prevent disease (before we see symptoms, when reversing damage becomes much more difficult). Seventy-one percent of Americans claim that wearable technologies have improved their overall health. By bringing the data right into our daily lives (it can’t get much more convenient than wearing it), people tend to be more accountable for their personal health and fitness, all of which can lead to a long life and less illness. There are devices that remind you to take medicines or keep up with healthy habits (fitness especially), help track nutrition, monitor/correct posture and more.

Wearable technology has the potential for a big impact on healthcare. Right now, a doctor’s interaction with patients is mostly limited to the office visit which gives the doctor a very small window into the daily life of the patient. Wearable technology can monitor key vital signs and send measurements of important data to the patient, caregivers and medical providers. Wearables also have enormous potential for research purposes.

The Best Fitness Wearables for a Healthy, Long Life

The Jawbone is a reasonably priced option that covers the basic measurements and features you’d want in a fitness tracker. Simply slip it on your wrist and track: activity (steps, calories burned and bursts of activity), sleep mode (tracks sleep time and quality and offers a smart alarm to wake you more easily during the best part of your sleep cycle) and a stopwatch you can set for timing exercise.

The Misfit Flash is a great option for first-timers and the budget-conscious, coming in at about $25-30. This wearable offers all the typical tracking you’d expect (sleep, steps/activity) but also does well timing various types of activity such as swimming and even sports. The Xiaomi Mi Band has gained incredible popularity in China, and is now available outside of China, as an ultra-affordable option. Get it on Amazon for as little as $18-27.

For those who want to monitor their heart rate, the Fitbit Charge HR is a great option. While covering the usual activity tracking, this one also does a great job as a heart rate monitor/tracker (and has a nice app with the ability to set challenges for yourself). You can also log food with a bar code scanner, food database and calorie counter.

Garmin also has a range of sophisticated options.

Stay tuned for more about all kinds of unique wearable health technologies and ways tech is changing healthcare, caregiving and our access to a healthy, long life. Sign up for our newsletter so you never miss out!

Sure, we all know it’s important to exercise. It’s one of the keys to living a long life but also one of the best ways to maintain an active, healthy lifestyle and feel great. Some of us have our exercise routines pretty well locked in, but might lose motivation or get bored at times. For others, it’s always been hard to commit to exercising on a regular basis. So, today we bring you FUN fitness ideas: unique programs (and help for specific “problem areas”), cool ways to take advantage of the outdoors, and free ways to work out and find fitness partners.

FREE Fun Fitness Resources

• Find exercise buddies with Meetup.com. Checking our local Meetup groups for fitness activities we quickly found a walking challenge group in Brandon, “Happy Healthy Living in St. Pete” which has had meditation meetups, sunrise runs, and co-working days for a holistic approach, paddleboarding groups, kayakers, and any number of running groups, bootcamps and more. Joining Meetup is free and it’s a great way to find exercise buddies, try different types of exercise, and meet people with similar interests.
• Check out the many Pinellas County community fitness centers and “free fitness zones”–outdoor areas with special fitness equipment (free/no membership required). Fees are involved for some of the community fitness centers but they tend to be quite affordable and may offer senior discounts.
• Find videos online to workout at home. Youtube has an endless selection of exercise videos, as well as experts demonstrating techniques.

Unique Fun Fitness Ideas

Try a completely new form of fitness (some specially targeted at concerns you might have):

• The Feldenkrais method (which is taught at Largo’s community center) “uses gentle movement and directed attention to improve movement and enhance human functioning” to help break rigidities. It has been shown to improve back and neck pain, balance and functional mobility.
• Yoga or pilates can be very beneficial to creating strength and flexibility. There are so many types and options. Suncoast YMCA offers yoga classes for the beginner, yogalates, Hatha yoga, chair and senior yoga free for members. Hot yoga can bring a new challenge (but, like all other forms of exercise, check with your doctor first) if you’re ready to heat things up a bit! And, for us lucky residents of Tampa Bay…take advantage of the beautiful environment with beach yoga (check out Meetup for more beach yoga and exercise groups). You can find Pilates classes at various fitness centers and specialized studios for reformer Pilates. There is quite a bit of research on the positive effects of Pilates on postural alignment, body composition, back pain, and balance.
• Dance: Pure Barre is an increasingly popular program that uses the ballet barre to perform small isometric movements set to fun music. It is considered a total body workout and people tend to see great results…plus it’s fun and different (and can bring you back to your ballet days!). For those who love to dance, you might also want to try Zumba (there’s also aqua Zumba and a more low-key version called Zumba Gold) or many other dance-cardio classes. An evening out ballroom or line dancing is great for you too!
• Tai chi and qi gong are great for body and mind. The Taoist Tai Chi society offers classes at the Dunedin Hale Center and several locations throughout Pinellas County (and the U.S.). Tai chi’s benefits for balance and reducing the likelihood of falls as you get older are well-documented. It is also a great stress reducer. Qi Gong an “ancient Chinese health care system that integrates physical postures, breathing techniques and focused intention.” It heals body and mind, due to its focused attention on breathing and movement. Both of these are offered at a number of community centers in Pinellas County.

Fun Fitness in the Great Outdoors

Getting outside and exercising in the fresh air is one of the best things you can do! If you live in Tampa Bay, there’s nothing better than a walk on the beach; walking, running or biking on the Pinellas Trail (and others); joining a friend for a stroll across a bridge for a sunset view; or hiking around one of our many parks. What about trying paddleboarding or kayaking? Bring a friend or your EasyLiving companion, join a meetup or just get out and enjoy some quite time by yourself.

• Make a goal to do one active outdoor activity/week, especially checking out new areas (there’s probably places you haven’t explored within 5 minutes of home).
• Add simple outdoor activities to your regular routine: do some gardening, take a quick stroll after dinner, attend festivals where you spend time walking around, park further away when shopping, or walk for your local errands.

Ok, you’ve got no excuse now! There’s something for everyone (and every budget) on this list so get out there and get active. Join us on our Facebook page for ongoing fun fitness tips and to share your success stories.

The surprising story of Japan’s Nagano Prefecture, once plagued by high blood pressure and strokes, now known for longevity among both women and men

The Japan Times recently published an article on “How Japan’s saltiest residents came to live the longest“, an interesting twist for those who credit Japan’s longevity to a diet filled with fish. Nagano Prefecture is a land-locked area, once known for digesting high levels of salt (used to preserve foods during long winters). Some of its most famous foods are preserved and pickled foods and a salty miso. So, how did this region go from being plagued by high blood pressure and strokes as recently as the 1960s to the highest levels of longevity in the world?

The solutions might surprise you! This story proves that people can make small changes that can make a dramatic difference in longevity (and quality of life). The area began tackling the issue by first focusing on the high salt diet, encouraging residents to make realistic changes. For example, instead of eating the salty miso soup with each meal, residents could cut back to once/day.

By adding more fresh vegetables (which refrigeration had made possible), people could still eat favorite foods but reduce the salt in their overall diets. The average Nagano resident consumes more vegetables each day than other Japanese people. This advice was echoed many times over at a recent Johns Hopkins women’s conference I attended, with a constant refrain from gerontologists, aging specialists and other researchers that a plant-based, nutrient-dense diet is essential to health and longevity.

The life expectancy for Nagano residents (from a 2013 study) is 80.88 years for men and 87.18 years for women. Japan’s national averages (2013) are 79.59 and 86.35, and the U.S. stands at about 76 and 81.

More than just living a long time, this area originated the concept (and slogan) of being “spry and energetic” in life and dying “a quick and painless death”. This concept of healthy life expectancy is increasingly popular, as most people worry that with longevity can come decreased quality of life. The question really becomes how can we not only live longer, but live better (i.e. aging wisely!). To read more about some of the ways Japan is tackling this question check out EasyLiving’s recent article on “Rethinking Aging: Lessons from Japan“.

So, what can you learn from Nagano’s residents to increase healthy longevity and age wisely? The surprising news is how easy it can be to make small changes (residents weren’t told to turn to the latest diet trend or completely eliminate anything).

• Consider implementing one small change in diet (e.g. eating meat-free one or two days/week, reducing sugary drinks to once/day, adding one serving of vegetables to each meal, using more herbs and less salt) immediately. Try the great recipe in the Japan Times article and use online resources for new ways to make veggies delicious. See how you feel and determine ways you can make additional small changes this year.
• For healthy, happy aging make small changes in lifestyle, one geared toward physical activity (parking further away to add more steps, taking a short walk each morning, trying a stretching or balance exercise video for a few minutes each day) and one geared to social/intellectual stimulation (taking a course or joining a new activity, setting time aside for lunch with a friend once/week or to Skype with family members). Think back to a hobby or interest you once enjoyed that perhaps you have given up, and find new ways to bring it back into your life!

For more longevity secrets, aging wisely advice, health research and more:

Are you on the path to aging well? What factors lead to healthy, happy aging? What do great examples of aging well have to teach us?

Take the Aging Wisely quiz to gauge how you’re doing on aging well.

Aging Well and Wisely Quiz

Do you regularly get recommended health screenings?          ◊ YES     ◊NO

Do you have a primary care physician?                                       ◊YES      ◊NO

Do you get some form of exercise, at least 3 times/week for 30 minutes or more?

◊YES      ◊NO

Are you a non-smoker and do you drink fewer than 2 alcoholic beverages/day?  ◊YES     ◊NO

Do you eat vegetables and fruit every day/have a primarily plant-based diet? ◊YES      ◊NO

Do you limit intake of processed foods (no more than a few servings/week)?  ◊YES      ◊NO

Do you have a technique/activity that helps you reduce stress? ◊YES      ◊NO

Have you read a book or watched a film in the last month?    ◊ YES     ◊NO

Do you volunteer in the community or participate in church/civic activities? ◊ YES     ◊NO

Do you smile or laugh at least 3 times/day? ◊ YES     ◊NO

Do you have a close companion to share your life with or do you see friends or family daily?

◊ YES     ◊NO

Have you completed the following documents?

Healthcare Surrogate ◊ YES     ◊NO

Durable Power of Attorney ◊ YES     ◊NO

Living Will ◊ YES     ◊NO

Trust/Will ◊ YES     ◊NO

If you get sick and are unable to care for yourself, do you know how you would like to have care provided?*                   ◊ YES     ◊NO

If you need long-term care, do you know how you will pay for it?* ◊ YES     ◊NO

Score your quiz. Are you aging well?

Tally the # of questions for which you answered “yes”.

13 or more: You are a master of aging wisely! You have done some preparation and you live out your day-to-day life in a way that supports longevity and quality of life.

9-12: You are aging well, but could take a few extra steps to ensure the best quality of life as you get older.

Less than 9: There’s always time to implement changes to age well! Commit to make some small changes or do some prep work this year.

We will be expanding and updating our Aging Wisely quiz in 2016 so make sure to check back for more! Throughout this year, we’ll be sharing our experts’ advice on aging well along with the latest research, technological advances and interviews with expert specialists. Sign up for our newsletter to get the latest updates.

*For more information about paying for long-term care, check out The Costs of Long Term Care and Paying for Home Care. We will be providing the updated figures on long-term care costs in an upcoming post. For help with care options, we recommend a care consultation with one of our aging life care professionals.

Want to stay healthy in 2016? Of course you do! But, those healthy new year’s resolutions go by the wayside very quickly. Preventative medicine is one of the easiest ways to stay healthy and know where to focus your efforts. Fortunately for older adults, Medicare pays for a great deal of preventative medicine.

Let’s start the new year with two simple actions you can take to make being healthier in 2016 easier!

Preventative Medicine Covered by Medicare

Check out Medicare’s full listing of preventative medicine and screenings covered in 2016. Your Medicare Part B will pay for these services with no cost to you!

When you first join Medicare, you are covered for a Welcome to Medicare visit (eligible for the first 12 months you’re covered). The preventative care visit includes a review of your medical and social history, basic screenings (BMI; height, weight and blood pressure; simple vision test; safety and depression screening), an opportunity to talk about advance directives; education about preventative services; and a written plan for screenings, shots and preventative medicine (as well as referrals to other medical care, if needed).

Thereafter, you are eligible for an annual wellness visit. You will fill out a health questionnaire to help your doctor create a personal prevention plan for you. The annual visit includes: a review of your medical history; pulling together (or updating) a list of current providers and medications; height, weight, blood pressure, and other key measurements; cognitive impairment screening; personalized health advice (risk factors and treatment options, along with a screening schedule of the preventative medicine you need).

We advise you to take advantage of this vital preventative care and put together a plan with your primary care physician. Action for good health in 2016: Take a look at when you last did a wellness visit, and contact your doctor’s office to schedule for this year (it’s covered as long as 11+ months have passed).

Care Coordination in Preventative Medicine

Speaking of which, do you have a primary care physician who serves as a good partner for your health? This is essential in managing your health. If you do not currently have a primary physician looking after your health (or are not happy with your current provider), contact our team for recommendations. Older adults may want to consider a gerontologist, specially trained to meet your needs (though they are in short supply in many areas).

Action for good health in 2016: We recommend a patient advocate consultation to ensure your records are organized (and available) and to identify any gaps in care coordination. Our patient advocates can make the task of getting organized super easy and can reduce the stress of navigating your healthcare. We have simple tips and resources to improve coordination of care and get you better results.

Throughout the year, our patient advocates will continue to share actionable advice and excellent resources so that you can age wisely and well. Linda Chamberlain also shares insight, personal stories and a wealth of knowledge (over 25 years in elder law, social services and healthcare) in Linda’s Journal. Don’t miss anything…sign up for our newsletter!

In case you missed them, here are some of our top Aging Wisely advice posts from the past year. As always, we covered an array of news related to caregiving, Medicare and eldercare issues as well as general aging wisely advice and resources. We try to answer questions clients and families frequently ask, and share the wisdom of our expert Aging Life Care Professionals™. In the coming year, we plan to bring you the best aging wisely advice and tips to help take more control of your health and well-being!

What do you want to know in 2016? Please leave us a comment here or on our Facebook page! The Aging Wisely site is for you!

Finding the Right Gifts for Older Loved Ones

Our most read page for 2015 is our Gifts for Seniors page. This page has been consistently popular for many years, and we’ve updated it and added a special gift coupon for our users. We also do seasonal and special needs posts to cover a whole range of options. Linda’s Holiday Gift Ideas have already been incredibly popular…they’re the Oprah’s picks for your older friends (and really good for most any age)! Other popular gift posts include: Gifts for Caregivers and People Facing Illness, Mother’s Day Gift Ideas and Gifts for Older Fathers.

Respite Care: Breaks for Caregivers

“What Will Respite Care Cost?” was our second most popular post in 2015. This is great news to us as we strive to support caregivers and ensure they get the help they need. Another popular post was “Caregiver Breaks: Do You Know Your Options for Respite?“. If this topic interests you, our EasyLiving team has put together a great checklist to help caregivers prepare for respite care. Use this checklist for a successful respite care experience.

Aging Wisely Advice on Hospital Discharge Planning

There’s been a lot of focus in the medical community about the problem of hospital readmissions for the elderly. Older adults tend to have multiple medical conditions and medications and are prone to complications after hospitalizations or surgeries. Therefore, a post-discharge plan for an older adult needs to be more comprehensive than a simple list of what to take and what to avoid. Many families still find the hospitalization and discharge process overwhelming. Two popular tools we created to help families with the transition are: the Hospital Discharge Planning Checklist for Families and Stroke Rehabilitation and Planning.

Other Popular Resources and Aging Wisely Advice

Eldercare Tools: The Florida Durable Power of Attorney

Sundowner’s Syndrome in Alzheimer’s Disease and Other Dementias

A Daughter’s Experiences in Eldercare: Detailing a client’s two very different experiences caring for aging parents

What is Medicare 2016 Going to Cost Me?

To get the latest and greatest from our experts on these topics and more, sign up for our monthly newsletter!

Gifts for People in Nursing Homes and Assisted Living Facilities

It can be especially tough to think of gifts for people in nursing homes, since their space is limited and much of their activity may be limited to the nursing home setting. A person who has moved to an assisted living facility often just downsized, so you want to get something that will really be used. Our expert team is here to help with ideas for gifts for people in nursing homes and assisted living!

As an added bonus, we have an exclusive coupon code for Silverts.com, which offers adaptive clothing, socks, shoes and many items specially designed for someone living in a nursing home:
Get My Senior Gifts Coupon

Here are our top 5 categories of gifts for people in nursing homes or assisted living:

1. The gift of time: one of the most appreciated gifts for people in nursing homes is the gift of your time and attention. Take time for special visits (ideal if you can make it a routine thing, as this can become something your loved one really looks forward to) or plan an outing. This holiday season, check with the person’s community church about special services or find a holiday concert or play.
2. Comforting items: soothing/favorite music, audiobooks, inspirational books, puzzle/activity books (coloring books made specifically for adults are an enjoyable stress reducer!), movies, favorite snacks/treats (check for diet restrictions and be aware that storage for food items may be limited in a nursing home), etc. Help make it convenient for your loved one to access comforting activities (i.e. give an iPod, pad or other device and load it with music, audiobooks or their favorite church’s podcast; buy a small TV with DVD player and a stack of favorite movies; install a mini-fridge by the bed so your loved one can have his/her favorite cold snack or drink). Just check with nursing home staff about space issues, any restrictions or recommendations. Check out Linda’s Holiday Gift Ideas for more comfort-related gifts.
3. Decorations for the room: you could simply buy inexpensive holiday decorations (dollar stores are great!) and surprise them by decorating their space, or you could buy 1-2 nice items (seasonal or not) to make their space special.
4. Homemade, personalized items: examples include homebaked goodies, art work from the grandkids, a scrapbook/collage or framed photo, or a handknit blanket or sweater (or buy one and get their name or initials embroidered on it).
5. Unique gifts designed for seniors or for specific needs, such as our gifts for people with Alzheimer’s. Other useful items might be adaptive clothing, shoes designed for specific conditions or health technologies.

Unfortunately, there are many seniors in our community (particularly in nursing homes) who don’t have anyone to buy them gifts or spend special time with them. For this reason, our team has participated in Elves for Elders for many years, assisting with various aspects such as organizing, serving as a gift drop-off site and promoting the project. If you’d like to help out buying gifts for people in nursing homes in Pinellas County, check out Elves for Elders to learn more.

The Medicare 2016 costs are out! We’ve updated our Medicare fact sheet to reflect the new numbers, and we invite you to download it and share (link below).

Medicare 2016 Costs

This is a breakdown of the Medicare 2016 costs, and the related comparison costs for 2015:

*If you were not previously enrolled in Medicare Part B, do not receive Social Security or are dual-eligible for Medicare and Medicaid, the standard benefit for 2016 is $121.80 (dual-eligibles’ costs are picked up by the state’s Medicaid program, however). Higher income individuals ($85,000 for individuals, $170,000 for couples, based on your tax return from two years ago) pay an adjusted amount, up to $335.70.

When eligible for Part A Skilled Nursing Facility coverage following a qualifying hospital stay, the co-pays are as follows:

• Days 1–20: $0 for each benefit period.
• Days 21–100: $161 coinsurance per day of each benefit period ($157.50 in 2016).

To read more about Medicare costs 2016 and get a concise overview of Medicare’s parts and coverage, download our free 2016 Medicare fact sheet.

Contact our healthcare advocates at 727-447-5845 for personalized Medicare advice today! Time’s running out for the open enrollment period to analyze how you might save money on Medicare costs in 2016 and make change.

We’re here to help you and your family age wisely and well.

As advocates for our elder loved ones, we need to be particularly aware of the potential risks they face during and after a hospitalization. More attention is being paid to discharge planning and hospital readmissions in recent years and efforts are being made to improve care coordination and discharge planning.

Thanks to Elizabeth E. Hogue, Esq.* who recently shared this news on proposed changes to discharge planning regulations (published November 3, 2015).

Unfortunately, elders are the targets of many scammers who see them as easy targets and know they often have money in the bank. For more information and tips on protecting your elder loved ones from scams, check out Top 10 Scams Against the Elderly and Tips for Fraud Prevention. There are some scams specifically targeted to or related to veterans, so today we bring you some top scams targeting veterans to watch for as well as tips about what to do to try and avoid being scammed. We encourage you to share these with your loved ones who are veterans (and share our gratitude for their service!).

Top Scams Targeting Veterans

1. Fake discounts for veterans. Obviously, some organizations offer genuine veterans’ discounts and specials, but others will offer false deals which may cause a veteran more money or serve to build trust so the vet leaves his/her guard down. Check carefully and comparison shop offers with and without special discounts.
2. Phishing. This is one of the most common scams targeting veterans and many other groups. This is a way for someone to get personal information to steal your identity or perpetrate fraud against you, by making you believe it is a legitimate request for information. People may have experienced this when a scammer posed as a financial institution or government organization. In the case of phishing scams targeting veterans, the person (or email) may claim to be from the Veteran’s Administration needing to update records. Never give out personal information to someone who reaches out to you. You can always contact the organization directly to find out if they need something.
3. Requiring payment for military records. This involves veterans being tricked into paying for access to documents that they can get for free. Once again, check directly with the VA if you need documents or have questions to find out about what’s available and charges. For our Florida veterans, we highly recommend the county Veterans Services Office where employees are available to answer your questions and assist you in navigating the Veterans Administration and benefits. Contact our team for help with this and other resources!
4. Bad investment advice or frauds related to investment. Investment advisors may target veterans, saying that they specialize in helping Vets or even calling themselves “Veterans Advocates”. This can be legitimate, but others may offer inappropriate investment vehicles for you or even may flat out try to steal from the person. Similarly, others offer “free help” with applying for veteran’s benefits, usually targeting selling you investments that may not be in your best interests (and might disqualify you for other benefits such as Medicaid, even in the future).  If you have a trusted investment advisor, talk to them before making changes. Regardless, do your research into any investment assistance or advice you receive.

Scams Related to Veterans

1. Charity Scams. False charities (or very poorly managed charities with high overhead going to salaries and perks for those involved) may solicity money from you. Those related to veterans may be especially busy around key times like Veteran’s Day, Memorial Day, etc. Check CharityNavigator.org.
2. Fraudsters posing as servicemen/veterans. The Nigerian email scams in which someone tries to get money from the individual with false claims such as lottery winnings or a relative in need are fairly well known (but remain successful) but now scammers also pose as a lonely serviceman looking for love or a veteran in need of assistance. Never wire money to anyone you don’t know and ignore unverified emails/requests.

For more information and resources:

Financial Fraud Enforcement Task Force information for servicemen/Veterans
Consumer Protection Bureau

As we shared in our recent post, some Medicare beneficiaries could be facing a steep hike in their 2016 Medicare premiums. Part B premium increases are tied to Social Security COLA (Cost of Living Adjustment), and since there will be no COLA in 2016 (announced October 15^th) most (about 70%) of Medicare recipients fall under the “hold harmless” protection and will not pay more. However, the remaining 30% (those not receiving Social Security, new Medicare enrollees, and high income individuals) could be facing a base rate increase of 52% (from $104.90 to $159.30) on their 2016 Medicare B premium. The premium scales higher based on 2014 income (up to $509.80).

The potentially good news is that a bipartisan budget proposal which recently passed in the House of Representatives would offer relief for these 30% of Medicare recipients*. Under this budget, the 2016 Medicare premium increase would be reduced to about a 14% increase. In this proposal, the costs for Part B would be covered by a treasury loan, gradually paid back by incremental Medicare premium increases.

There are some other provisions in this budget that might affect you or your loved ones. First, on a positive note, it addresses potential cuts to Social Security disability payments, by reallocating some of the payroll taxes to this program. On a less positive note, some households may be losing Social Security benefits (those receiving benefits under a spouse, ex-spouse or parent’s work record…if that person has suspended his/her benefits).

Get all your 2016 Medicare News!

We will keep you updated on the progress of this bill and other 2016 Medicare news. We invite you to sign up to be one of the first to receive our 2016 Medicare fact sheet, as well as our monthly insider tips.

You may want to read our article about Medicare 2016 open enrollment as well.

*Update: The bill was passed in the Senate.

Our experts help with your frequently asked eldercare questions. With the holidays coming up this is an especially timely topic: handling holiday (and other) visits when your loved one lives in a nursing home.

Can I take my loved one out of his/her nursing home for an outing or holiday visit?

Yes, residents of nursing homes can definitely leave the nursing home for outings and visits with family. Of course, the nursing home is regulated tightly and residents are considered to be under medical care while there, so it is necessary to follow certain procedures.

You should talk to your loved one’s nursing staff about outings, to ensure the person’s safety and well-being. The staff can also prepare you for what might be needed during the trip, such as equipment and care needs. If you have not personally taken care of your loved one alone in some time, it is important to understand their needs before planning a nursing home outing.

Typically, you will need to “sign out” a nursing home resident and talk to the care staff about the plan and timing of the visit. It is important to let them know the intended length of the visit and keep in touch if anything changes, so they can plan accordingly. There are also financial implications for overnight/longer visits.

Florida Medicaid Rules for Holding Nursing Home Beds

In addition to whether or not you can leave a nursing home and what type of visits are advisable, costs are an important factor to consider. If a resident leaves a nursing home overnight, they (or some payment source such as Medicaid) would need to continue to pay the cost to hold their spot. For a private pay resident, monthly payment would simply be as usual and then the bed would be held (for longer stays away from the nursing home–even hospital stays, the resident/family would have to determine if they wish to pay to hold the bed).

This is known as a “bed hold” in Medicaid terminology and the policies vary by state. For what is known as “therapeutic leave”, Medicaid in Florida pays the nursing facility to reserve a resident’s bed a maximum of 16 days per fiscal year (July 1-June 30). Therapeutic leave means the resident leaves the facility to go to a family-type setting (not another nursing home or hospital). Each night away counts as one day.

However, the nursing home must have at least 95% of its Medicaid-eligible beds filled in order to bill the state for bed hold days (presumably, if not, there would be sufficient open beds for the person to return). If a resident exceeds the yearly allowed days, the resident or family could also pay privately to hold the bed. If they do not wish to do so, the nursing home may discharge the person but must readmit them in the 1st available Medicaid semi-private bed (of course, it does not have to be the same room as before).

The nursing home should provide this policy in writing, at admission and again when you go on any therapeutic leave. For a complete list of Medicaid bed hold policies by state click here (check with your state to see if the policies have changed since this was updated).

Medicare Skilled Nursing Coverage and Leaving the Nursing Home

Medicare only covers short-term skilled nursing care, so this isn’t an issue for most nursing home residents. However, if you are in a skilled nursing facility receiving treatment under Medicare and wish to leave to visit loved ones for the holidays, can you?

Despite what you are sometimes told, Medicare does not necessarily consider a family visit to mean you don’t need skilled care. You can be gone during the day (attending an outing, but back by midnight that day) and the facility can still bill Medicare for the day. If you stay away overnight, the facility typically can’t bill Medicare for that day. You can talk to the facility about their bed hold policy, and you may be able to privately pay to hold the bed if you wish.

Remember, however, that missing out on therapy services, in particular, may slow your recovery process and you may benefit less from your time in the skilled nursing facility. It is best to discuss your needs and scheduling of any visits with your care team.

The Logistics of a Nursing Home Outing

We have many clients who we arrange regular outings for, often with the help of a nursing assistant. We would never want our clients to feel that the nursing home is like a prison, but we also want to make arrangements to make any visit safe and comfortable.

Talk with care staff about the details beforehand and consider whether some assistance might be needed. You can arrange special transportation or an aide to go along with the person, to assist with transferring, going to the bathroom and other needs that may arise.

Our senior caregivers have shared tips and information about traveling with someone with dementia and they offer senior concierge services to plan events/outings and escort the person (even on long-distance trips to visit family).

We can also help with creative ideas for making the holidays special for your loved one residing in a nursing home or assisted living. Contact us for ideas or help with nursing home visits, concierge services, patient advocacy and more.

Also, don’t forget to check out our Senior Gift Guide!

Our Medicare advocates are here to help you understand Medicare as we’re in the midst of the Medicare 2016 open enrollment decision making. Today, we’ll answer some FAQs about Medicare, such as “What is Medicare going to cost me in 2016?” and “What is Medicare going to cover in 2016?” and “Will I be subject to a big Medicare Part B increase?”. We also help you find a broad range of information, such as “What is Medicare?” and “What is Medicaid?” and when you need to sign up and take certain steps.

What is Medicare going to cost me in 2016?

All of the numbers are not out yet, but sign up for our newsletter to get all the details as soon as they come out! We do know what Medicare Part D’s maximum deductible will increase from $320 to $360. Of course, this is only the maximum limit placed on the plans. Your drug plan may have no deductible at all and can range up to $360 (however, a Kaiser Family Foundation issue brief revealed that 2/3 of all Part D plans will have deductibles and a growing share will have the maximum deductible in 2016).

Part D plan premiums vary widely (as do the associated costs for covered medications) so it is important to analyze the best plan for your current situation during open enrollment. For 2016, the chart below details the income-adjusted premiums for Part D. In other words, if you are looking at a particular Part D plan and your income is more than $85,000 (or $170,000 for joint filers)–based on your 2014 return–you will need to add the extra cost to this premium to get your true monthly cost.

The average Part D premium is projected to increase by 13% from 2015 to 2016 ($36.68 to $41.46). Even if a number of beneficiaries switch/are reassigned to lower-premium plans, the average increase is likely to be the largest since 2009 (Kaiser Family Foundation).

Most of the other Medicare costs will likely stay similar to 2015. However, a big area of concern for some Medicare recipients is the potential 52% hike in their Medicare B premium if they are not protected by the “hold harmless” rule.

What is Medicare “hold harmless” and will I be subject to a large Part B premium increase in 2016?

Social Security benefits will not get a COLA (Cost of Living Adjustment) next year, which means that most Social Security recipients who are also Medicare beneficiaries will not see an increase in their Part B premium ($104.90–stable since 2013) under Medicare’s “hold harmless” provision. But this “hold harmless” rule doesn’t apply to about 30% of beneficiaries: those who are not yet receiving Social Security, new Medicare beneficiaries, individuals earning more than $85,000 a year (or $170,000 for joint filers), and Medicare/Medicaid “dual eligibles” (though for dual eligibles, the burden will fall mostly to the state Medicaid programs).

Unless Congress or the administration make some modifications, these Medicare beneficiaries will generally be facing a Medicare B premium of $159.30, with higher income retirees paying as much as $509.80/month.  The Part B deductible for these beneficiaries would rise to $223 next year (from $147 in 2015). This is due to the fact that premiums must cover cost increases within the Medicare program, and since about 70% of people are protected by the hold harmless rule this puts a large share of cost on the remainder.

What is Medicare open enrollment, when is it and what to I need to do?

Medicare open enrollment is your chance to switch Medicare D plans for 2016 (and switch to/from Medicare Advantage). Read more about Medicare open enrollment 2016 and what you need to do during this period (October 15th-December 7th). If you need help with this process or initial Medicare enrollment, our Medicare advocates can assist with our Medicare Analysis Package.

Find out more about Medicare and Medicaid at:

Aging Wisely’s Medicare Fact Sheet (2015 version), includes all the basic facts about Medicare and key dates

Medicare.gov: get your Medicare 2016 handbook, compare plans, find out what Medicare covers and more

Medicare Interactive answers questions about Medicare rights and benefits, run by the Medicare Rights Center.

What is Medicare? What is Medicaid? Who Pays? by EasyLiving’s senior care experts, with links to fact sheets about Medicare’s coverage of home health care and other resources

Contact our healthcare advocates  for any questions about Medicare, Medicaid, other benefits and your health needs. We do not sell insurance or any products, so our opinions are based on our experiences helping many families and our analysis of what’s best for you!

What is Sundowners Syndrome?

Sundowners describes the phenomena of irritability and other symptoms that occur in the late afternoon and evening in people with Alzheimer’s disease and other forms of dementia. The symptoms a person “sundowning” may experience include restlessness and wandering, agitation, delusions, increased confusion and more.

Many dementia symptoms are simply exacerbated during this period of the day, or your loved one may almost seem like a whole different person when the evening hours hit.

Scientists aren’t sure what causes Sundowners Syndrome. It is likely related to the fading light and perhaps the disturbed sleep cycles and body rythyms caused by dementia. I have always thought that our circadian rythyms and lifelong patterns may play a big role (i.e. this is the time of day when we usually expect transition…leaving work, family arriving home from school/work, preparing for dinner, relaxation, bed). Many times the people sundowning seem to be anticipating that something is supposed to happen, that they should be going somewhere or want to “go home”.

Sundowning can indicate that the person is worn out, in some discomfort, or feeling hungry or thirsty at this point in the day. The person may also be sensing the caregiver’s own frustration or exhaustion at the end of a long day.

How can I manage my loved one’s Sundowners?

• Plan. Anticipate that this can be a tough time of day and schedule accordingly. Don’t plan outings or other activities which might be difficult during this period. Be prepared to provide closer attention and learn ways to redirect your loved one (enlist extra help if needed).
• Prevent. Try to ensure your loved one gets plenty of rest, food and drink. Watch for subtle signs of pain or discomfort. Regularly help him/her to the bathroom. Make sure the temperature is comfortable.
• Soothe. Use soothing music or other activities to create a sense of calm. Find out what works best for your loved one.
• Adjust lighting. Turn on good quality lighting as daylight fades. Consider closing curtains to reduce shadows.
• Provide a safe environment/outlet for pacing and wandering. If your loved one is prone to pacing, you may want to plan walks in a safe area during this time or create a space where he/she can walk around without wandering away.
• Check out our Dementia Symptoms slide show, with practical suggestions for help with wandering and other behavioral symptoms.
• Talk to your doctor about the sundowners symptoms your loved one is experiencing. Sometimes medications can help, or the doctor may need to adjust current medications or address sleep issues.

Contact our eldercare team about dementia caregiver support and resources, dementia home care or respite care and more. For more sundowners, dementia and eldercare resources, sign up to get our free monthly tips.