As elder advocates, we are always glad to share important educational information. We were recently contacted about an upcoming online event focusing on elder abuse. Please take a look at this important information and consider sharing it with others as well. This vital information does not receive enough attention.

Elder abuse remains a drastically under-reported crime because of factors such as the victim’s fear of losing independence. There are also many challenges to investigation and prosecution, so justice is often thwarted.

Here are some of the top myths that hinder the successful prosecution and investigation of criminal elder abuse:

• Elderly people make terrible witnesses.
• If the elderly victim refuses to provide information, nothing can be done.
• If an elderly victim gives money voluntarily, it is not a crime.
• If the victim is deceased, you cannot prosecute.
• Any case where the elderly victim is involved in a home repair dispute involving money is a civil matter.
• Suspects of elder abuse never call 911.
• Elderly people die from natural causes, without investigation needed.

Get the real story and learn how to protect yourself or your elderly loved ones by attending a free online event April 10th 9am – 4:30pm EST. Be an advocate for elders! Register here and help the National Crime Prevention Council fight these awful crimes.

Aging Wisely’s team of patient advocates brings you the latest news and information relevant to caregiving, healthcare and disability care. Our weekly blog posts are designed to inform and answer some of the most frequently asked questions we get from families. We also send out a monthly “Wise Words” newsletter, and if you’d like to receive it you can contact us online with a request.

As we wrap up 2013, we thought we would share some of the top news stories we reviewed this year and their implications for you.

Healthcare Reform and Obamacare

Obamacare was one of the stories that clearly got a lot of press in every type of media outlet. A lot of the current/coming changes related to Obamacare are not directly related to most seniors, however. All the press about the changes did have one negative effect on some seniors, however, in that scammers used it to their advantage. They preyed on the confusion over Obamacare in order to obtain personal information or extract unnecessary fees from elders.

Seniors who are covered under Medicare are not affected by Obamacare mandate. There were various changes made to the Medicare program with the health reforms, such as the gradual closing of the Part D doughnut hole and expanding preventative care benefits. Medicare recipients do not have to choose new healthcare plans under the exchanges, as they will continue to be covered by Medicare. As usual, Medicare recipients have annual opportunities to make changes to plans and there likely will be some changes to the Medicare Advantage landscape as incentives/pay structure changes. To read more on this subject, check out “What to Expect from Medicare in 2014” and “The Aging Wisely Medicare 2014 Fact Sheet“.

On the other hand, Aging Wisely’s patient advocates work with many disabled, chronically or critically ill clients who are not currently covered under Medicare. Some of the Obamacare changes offer new options for these clients. You can get an overview of the changing healthcare landscape here and contact us if you need help navigating these issues.

Assisted Living Exposé Reveals Problems in the Senior Living Industry

PBS Frontline did a piece entitled “Life and Death in Assisted Living” which exposed information behind several lawsuits against Emeritus Senior Living. The piece examined the larger picture of regulation and consumer protections in this massive industry. As we know as advocates, there is good and bad care in any setting. These types of issues have been uncovered in hospitals, nursing homes, in-home care and all types of institutional care over the years. Much of the financial abuse and neglect that elders face is actually perpetrated by family members, but this special did uncover some issues within this industry that should not be ignored. Assisted living was virtually non-existent 30 years ago so this is still a relatively new industry adapting to a drastically changing clientele. The population in most assisted living facilities is now much older and sicker than originally envisioned.

In our article on this topic, we focused on what we think is most important to families about this story. Rather than simply instilling fear, we hope to provide concrete ideas of how you can better evaluate care options and advocate for your loved ones. As long time elder advocates, we provide some of our key advice on finding quality assisted living care and ensuring quality eldercare after moving in to assisted living.

The World’s Aging Population

Florida has been a unique place for our Aging Wisely team to work. Our demographics in Florida have been “ahead of the curve” with a large elder population well ahead of the much discussed Baby Boom/Age Wave. Clearwater and St. Petersburg, Florida lead the statistics in terms of elder populations among similar cities of their sizes. We also have a large demographic of people who have retired to Florida from other locations, often with family members living elsewhere. These types of demographics are becoming more widespread as the Baby Boomer generation ages and society becomes ever more mobile. On a larger scale, this phenomenon is international in nature. While developing nations may still have lower life expectancies and higher birth rates, many nations are facing an aging population and drastically lower birth rates as people marry later and have fewer children.

In the European Union, for example, life expectancy (which rose by eight years between 1960 and 2006) could continue to increase by a further five years between 2006 and 2050 and would thus result in a larger proportion of people surviving to the ages of 80 and 90. The average number of children per women stands at 1.5 whereas the replacement level is 2.1. Immigration is offsetting these lowered population numbers in many countries. Therefore we are looking at very different dynamics in terms of issues like pensions, the makeup of the working population and family caregiving.

Japan has the world’s highest percentage of population over age 65 and this occurred in the shortest time span (again related to both higher life expectancy and lower birth rates). China is a different case, where declining birth rates have been, at least in large part, caused by government policy (the “one child policy”). Of course, rapid economic/lifestyle improvements have impacted the other side of the equation, with greatly extended life expectancy. This has led to what is known as 4-2-1 conundrum, in which each (only) child has four grandparents and two parents to care for. Filial piety is a traditional value and many families live in multi-generational households, but migration and the one-child policy have put strains on this system of family care. China has been dealing with this in various ways, from a policy in which parents can sue children for not visiting to small subsidies for elders whose only child died or is disabled. Institutional and private care options are also beginning to develop, with home care companies providing in-home support, the first private assisted living facilities opening, and Buddhist temple-based nursing homes. There is also an interesting eldercare volunteer program being tested.

With globalization and shared information, nations should be able to learn from each other and determine the best options to care for their older citizens. The U.N. began looking at these issues in 1982. In 2002 the Second World Assembly on Ageing in Madrid led to the plan of action on ageing which “called for changes in attitudes, policies and practices at all levels to fulfill the enormous potential of ageing in the twenty-first century.  Its specific recommendations for action give priority to older persons and development, advancing health and well-being into old age, and ensuring enabling and supportive environments.”

We want to extend our wishes for a happy, healthy 2014 to all our clients and friends! We hope that 2014 will be a year of good news and progress toward active aging and improved quality of life for all. We encourage you to check back with us for the latest news and information and contact us any time we can help!

You can reach our advocacy team via online contact or by calling 727-447-5845. We’re here to help with your Florida elder and disability care questions, patient advocacy issues, Medicare and much more!

As our previous blog post points out, the hospital discharge process is a key transition time. Without proper support and resources as well as good understanding of follow up instructions, many individuals will return to the hospital for reasons that could have been avoided. No one wants this, and it can be especially dangerous for elders and persons with chronic conditions.

If you are a family caregiver and an elderly loved one is hospitalized what can you do to ensure a safe transition after the hospital stay?

• Consider the discharge process as beginning at the start of the hospital stay. Find out who is responsible for discharge planning and introduce yourself, explaining that you will be involved and giving relevant information about the patient’s living situation, supports and concerns. Discharge may not seem like a top concern at the beginning of a hospital stay, but with shorter hospital stay lengths, good groundwork starts as soon as possible.

• Keep good records. An online personal medical record system is an ideal way to manage your loved one’s health history, medications, and store key contacts so this information can be readily available. You can also use a notebook or file to store the information, as long as you have it available and provide good information to new providers. Make sure you communicate information that is vital to your loved one’s health, such as medications that really should not be changed or typical complications or concerns that arise during hospitalization or procedures.

• Get to know the medical staff and check in about what is going on throughout the stay. Ask questions (and keep records as per above) about procedures, tests, expected outcomes, medications.

• Understand that you or a designated patient advocate will need to take charge in being the centralized hub of information. This includes ensuring you understand instructions, what will happen after discharge, and the functional status of the person (and therefore what support might be needed). Ask questions and anticipate concerns that might arise and do not hesitate to voice them.

• Consider using a professional patient advocate for consulting or assessment during this process. Aging Wisely’s Care Managers know the discharge process, use a systematic approach and can help families anticipate needs and find resources to help. If you are caregiving from a distance, this support is vital as it is very difficult to manage the discharge process from afar.

• Plan for the immediate transition time. The first day or two after discharge can be particularly problematic. Think about practical issues such as getting new medications, food and personal items while needing to attend to a person in a weakened state. Will you be able to help the patient from bed to bathroom? Services such as Medicare home health care and medical equipment rarely arrive immediately and are not meant to fulfill “custodial” needs, so you may need additional home caregiver support.

• Find out about the options for services and rehabilitation after the hospital stay. There are essentially three rehabilitation options: inpatient (i.e. at a skilled nursing facility/rehabilitation center), home health care (for someone who is considered homebound) and outpatient rehabilitation (going to a clinic or center to receive therapy). We will cover these in more depth in a future post, including the insurance ins and outs & we invite you to contact us if you have immediate questions.

• Ask for thorough discharge instructions in laymen’s terms and explain that you would like to be there when they are reviewed with the patient. Make a list of questions and help ensure you and your loved one are clear on instructions and who to contact if there is a problem later. Here is one example of a simple discharge form that you can provide if the hospital does not have one.

• Know your patient’s rights, including the option to appeal a discharge if additional planning needs to be done to ensure a safe discharge.

Our next blog post will contain a checklist of items to consider and ask about when preparing for your elderly family member’s discharge, as well as more on resources to help during the transition of care.

Contact us if you have immediate questions. Our Florida geriatric care managers serve as your professional patient advocate, providing caregiver support and consultation, as well as geriatric assessments and resources.