Are Florida’s elders getting shortchanged? As a state with a high elderly population (Florida’s 65+ group makes up over 18% of the population whereas the U.S. average is 13%), many people assume Florida will be at the cutting edge of long-term care services and programs for the elderly and disabled. But, a recent study suggests otherwise.

The scorecard on long-term care services ranks Florida 43rd overall on five measurements, including nursing home affordability, quality of care and support for family caregivers.

States that have more generous Medicaid benefits (the primary benefits program available to help with long-term care costs; Medicare does not cover long-term care), and that spend more on home-based care, did best in these rankings. Florida spends 23.5 percent of its long-term care budget on home-based care, earning it a rank of 40th in the nation. And only 49 percent of low-income disabled Floridians receive Medicaid benefits (39th in the nation).

Minnesota ranked #1 in the study and some examples of what they are doing include:

• Additional protections for workers who take time off to care for a sick family member
• More help to enable people in nursing homes who are capable of going home to do so
• Allowing professional home health aides, to do more medical-related tasks (thus potentially saving costs when nurses are required to do these tasks only).

Each state faces different priorities and challenges, but families are often unaware of this great variation and have very little knowledge of what the options are in their state. It can be quite a shocking process when facing long-term care needs for a family member.

What can you do?

• Get a basic understanding of what your state offers and how programs work here. Follow local experts’ blogs and publications that cover long-term care and health issues to stay updated.
• If you have a loved one who needs long-term care or may need help in the near future, get information sooner than later. Begin to understand what is available and the process you will need to go through to access help. Read up on the diagnosis and managing various eldercare issues (hint: we have loads of great senior care links, home care information and free eldercare downloads for you). Even if you think family members can handle everything, knowing what support is available and having good information will better enable you to care for your loved one.
• Speak up if you have concerns. This might be on an individual or policy level. Don’t take no for an answer without doing some research and finding out if there are alternatives. Hiring an independent advocate (like our expert care managers!) can be a worthwhile way to understand the big picture and find creative solutions. Consider sharing your thoughts with your legislators. Your story and input can help them understand how policy decisions are really affecting constituents.
• Get help. Florida is offering more and more options, though families sometimes find the system very confusing to navigate. Get some help so you can understand the best options for your family. Little things can become roadblocks to getting services. If you don’t understand timing, forms, and procedures you may be denied an option that could really help. It’s also useful to have an outside party analyze your individual situation to help you look at pros and cons of different choices.

You can sign up to get our monthly Wise Words newsletter for more long-term care and eldercare information, timely news articles and more! Or, contact us for a free needs analysis today.

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!

Financial exploitation of seniors is a growing problem and often goes unreported. Many seniors are embarrassed to report scams or exploitation and fear losing independence if they admit they have been victimized. All too often, family members are the exploiters (Florida elder exploitation statistics indicate about 27% of cases were committed by a son or daughter.)

Some common Florida elderly scams and abuses include:

• Durable Power of Attorney Misuse
• Identity Theft
• Imposter Fraud
• Moving Scams
• Investment Fraud
• Annuity Fraud
• Home Repair Scams
• Charity Fraud
• Telemarketing or sweepstakes Fraud

Some examples of scams that are frequently targeted to elderly individuals living at home alone include: excessive or unnecessary home repair work or devices (water softeners for example) or work paid for but not completed; sweepstakes and lottery scams; “fishing” for personal information over the phone or email for identity theft purposes; distraction techniques (coming in to the home for a stated purpose and stealing items while the person is distracted).

Reducing social isolation and having trusted parties checking in on someone as they age can help reduce the likelihood of being a victim of a scam, or assist in quickly identifying concerns and stopping any ongoing fraud.

Resources for elder exploitation:

Safeguard Our Seniors http://www.flseniors.net/
National Center on Elder Abuse http://www.ncea.aoa.gov
Florida Abuse Hotline: 1-800-96ABUSE
Florida Elder Help Line: 1-800-96ELDER

Additional senior safety tips:

• Elders should talk with legal and financial advisors about how to prepare for aging and possible incapacity-what legal documents are needed, how to set up financial accounts and especially share any concerns about family members or family conflicts to be taken in to consideration when planning.
• Open conversations about wishes, paying for care, priorities and beliefs help families to better handle their loved one’s needs and possibly to be more aware of changes in patterns. A neutral party may help in facilitating these conversations.
• Families at a distance should consider having a trusted party(ies) to check in on a loved one who lives alone. A geriatric care manager can visit to provide some oversight and help to pick up on any changes that might be cause for concern.
• Always check out any parties hired to do work for an elder. It is best to use reputable companies/licensed agencies or providers. You can at least check to ensure it is a legitimate business and does not have a history of complaints. Talk to your loved one about some of the common scams and remind them that they should not hire unknown parties or let individuals in to the home.
• For in-home care in Florida, use a licensed home care agency which must adhere to state-required rules and standards. If your loved one has private caregivers, see our handout Caregiver Concerns to learn more and be aware of signs that might be red flags.
• Professional advisors can help families by being aware of major changes or red flags. In discussing future planning, discuss procedures and options if the professional has concerns and seek to open communications between family members. Help clients with alternatives and protective measures when family conflict exists or there is a concern raised about a particular family member. Be aware of mandatory reporting statutes and report possible abuse to the state hotline.

We’re here to help if you have concerns or questions about help for elderly loved ones in Florida. Contact Aging Wisely for elder advice, geriatric care management assessments, family caregiver consultations.

When one is depressed, he or she may not wish to do anything or see anyone. But isolation and inactivity only make depression worse. The more active you are—physically, mentally, and socially—the better you’ll feel. Isolation and inactivity can be contributing factors to depression in the elderly. Older adults who are socially connected and engaged in activities demonstrate high levels of life satisfaction.

Depression is not a normal part of aging-visit our article on signs and symptoms of elderly depression and contact us if you are concerned about someone you love.

Here are some suggestions for activities to reduce loneliness and isolation:

• Getting out in to the world – Staying home all the time leads to isolation and contributes to feelings of depression. It is important to be involved in some activities outside the home. For those with limited mobility, a home caregiver can assist with transportation and physical assistance to maintain activities.

• Connecting to others – Connections with other people are vital to mental health–this includes going out to visit, having loved ones and friends over, and keeping in touch via email or phone.

• Participating in activities you enjoy – It is vital to continue enjoying favorite past-times. One can modify activities to changing needs when ill, but many activities can be enjoyed despite any limitations. Families might consider spending time playing favorite games or cooking traditional recipes with loved ones, or can hire a personal companion to assist with hobbies. A computer may be a way to continue playing favorite games if getting out on a regular basis is difficult. Audiobooks (Pinellas County offers a Talking Books program, as do many library systems) can be used for those who enjoy reading but have difficulty with vision or holding a book.

• Volunteering your time – Helping others is one of the best ways to feel better about yourself and regain perspective. In Pinellas County and other counties in Florida, you can contact 211 for local organizations that might need volunteers.

• Taking care of a pet – Pets provide companionship and purpose. If your elderly loved one is moving to assisted living, find out about the facility’s policy on pets since many allow animals (though there may be size/type restrictions).

• Learning a new skill – Pick something that you’ve always wanted to learn, or that sparks your imagination and creativity. Local community and senior centers, such as the Dunedin Hale Center and the Clearwater Aging Well Center, offer a wide variety of courses and activities.

• Enjoying jokes and stories – Laughter provides a mood boost, so swap humorous stories and jokes with your loved ones, watch a comedy, or read a funny book.

• Maintaining a healthy diet – Avoid eating too much sugar and junk food. Choose healthy foods that provide nourishment and energy, and take a daily multivitamin. EasyLiving Pinellas home care provides meal preparation assistance for those needing help shopping, cooking and even having a companion with which to share a meal.

• Exercising – Even if you’re ill, frail, or disabled, there are many safe exercises you can do to build your strength and boost your mood—even from a chair or wheelchair. Your doctor or physical therapist can recommend an exercise program and there are numerous senior-oriented exercise options, at your local senior center, YMCA or gym.

Contact us if we can assist with resources for remaining active, getting help for a depressed senior or to answer your questions about geriatric care management services.

Helping Florida Serve the Geriatric Care Needs of its Senior Citizens

Florida has many great resources for senior care and aging assistance. Over the last century elderly people have been migrating to Florida for its warm weather and healthy senior environment. Many times they are geographically separated from loved ones but wish to stay in Florida, but need some eldercare support to do so. Here at Aging Wisely we hope to continue in this long tradition of serving our nation’s elderly parents, relatives and loved ones.

Below you’ll find a list of links and senior care resources we believe important to not only helping Florida seniors care for themselves but also nationwide and international citizens looking to make Florida their home and families at a distance concerned about elderly loved ones living in Florida.

Below you can find resources dealing with Alzheimer’s, Florida Caregivers, Geriatric Care Management, Florida Prescription Drug Information, along with Housing and Legal Issues. If you’re trying to make the best healthcare choices, we offer specialized Medicaid and Medicare advocacy and analysis.

The following links are great resources as you navigate your senior care journey, but we know it can be confusing to figure this all out alone! We encourage you to contact us at 727-447-5845 for a personal needs analysis or reach out online for further information on Florida eldercare, healthcare or geriatric care management.

ALZHEIMER’S

http://www.alz.org – Alzheimer’s Association

Alzheimer’s Specialty Home Care in Florida

CAREGIVERS

http://www.caregiving.com – Solutions to caregiving situations, managing stress and making decisions

http://www.caregiver.org – Family Caregiver Alliance, a non-profit organization for family caregivers and the professionals with whom they work (provides research, education, awareness, advocacy)

http://www.easylivingfl.com/blog/-EasyLiving Florida home caregivers’ blog offers a wide array of information for family and professional senior caregivers.

http://www.parentgiving.com – Information & Resources for Caregivers

http://www.ec-online.net – Online community for elder caregivers

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CARE MANAGEMENT

http://www.caremanager.org – National Association of Professional Geriatric Care Managers, information on the field of care management and links to geriatric care managers throughout the U.S. and in other areas of Florida.

Signs You Might Need a Geriatric Care Manager

Benefits of a Geriatric Care Management Assessment

DRUG INFORMATION

http://www.needymeds.com -This website offers comprehensive information on patient assistance programs and prescription drug information.

www.medicare.gov – Medicare’s official site

http://www.mypillbox.org – Allows you to make weekly medicine schedules, including pictures of medicines

http://www.ismp.org/ – Institute for Safe Medication Practices, a nonprofit organization educating professionals and consumers on safe medication practices

http://www.fda.gov/medwatch – FDA safety information and adverse event reporting program

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ELDER CARE/SENIOR ISSUES

http://www.easylivingfl.com – EasyLiving, Inc. provides home health care and senior home care services in Pinellas County, Florida.

http://www.eldercare.gov – The Eldercare Locator has a listing of government and local eldercare services (good place to find contact information, but will not offer recommendations).

http://www.benefitscheckup.org – Searchable listings of various benefits programs that help seniors pay for costs of food, utilities, prescription drugs, etc.

http://www.aoa.gov – Administration on Aging, created by the Older Americans Act

http://www.agingcare.com – AgingCare.com is an online community that connects people caring for elderly parents to other caregivers, personalized information and local resources.

https://www.agingwisely.com/category/blog/– Aging Wisely’s weekly blog posts cover the most current topics in aging, caregiver questions and insights from our eldercare experts. Leave us a comment or question you’d like answered!

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HEALTH ISSUES

http://www.nih.gov – National Institute of Health

http://www.caringinfo.org – Caring Connections from the National Hospice Foundation, information on end of life care and downloadable state-specific advance directives.

http://www.familydoctor.org – American Academy of Family Physicians’ patient information site, search for useful articles/topics related to seniors and family health

http://www.fdhc.state.fl.us – Florida Health & Human Services: Agency for Health Care Administration (state surveys of nursing homes, home health and other eldercare and healthcare organizations, healthcare regulation information and state updates)

http://www.apdaparkinson.org – American Parkinson’s Disease Association. The Information and Referral Center-West Coast of Florida can be contacted at 727-328-6246.

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HOUSING

http://www.leadingage.org – Previously called the American Association of Homes & Services for the Aging

Guide to Choosing the Best Assisted Living– Tips for choosing a care facility for seniors from our eldercare experts who know the inside scoop on care facilities

Florida Health Finder-Facility Locator – A listing of all regulated Florida health entities such as nursing homes, assisted living facilities and home health agencies, managed by Florida’s Agency for Healthcare Administration.

Senior Citizen Housing Information– U.S. Department of Housing and Urban Development’s information for seniors on housing assistance and various programs

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LEGAL ISSUES

http://www.naela.org – National Academy of Elder Law Attorneys – assists lawyers, bar organizations and others who work with older clients and their families – resource of information, education, networking and assistance

http://www.nsclc.org – National Senior Citizens Law Center – advocates nationwide to promote independence and well being of low-income elderly individuals and persons wit disabilities, with particular emphasis on women and racial and ethic minorities

Ask us for a referral to a local Florida elder law or estate planning attorney!

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MEDICARE AND MEDICAID

http://www.medicare.gov – The official U.S. government site for Medicare information. Includes search tools for helpful contacts, Medicare personal plan finders, nursing home information and frequently asked questions.

http://www.medicareadvocacy.org/ – Center for Medicare Advocacy

http://www.cms.hhs.gov – Centers for Medicare and Medicaid Services – information for consumers and professional regarding Medicare and Medicaid

Florida Health Finder’s Medicaid information – Florida Agency for Healthcare Administration’s portal for Florida Medicaid information and key contacts.

Medicaid Fact Sheet– The latest Medicare numbers and an overview of the various parts of Medicare, presented in a clear, concise manner.

Medicare Under 65 – Overview of information and resources for people under age 65 who may qualify for Medicare coverage, such as those with disabilities.

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ADDITIONAL INFORMATION & RESOURCES

http://www.aarp.com

http://www.va.gov – Department of Veteran’s Affairs

http://www.ssa.gov – Social Security Administration and Social Security Online

http://www.elderabusecenter.org – National Center on Elder Abuse

http://www.myflorida.com – The state of Florida’s official web portal, with a wide variety of information and links on government services. Contains specific sections on elders ans retirement in Florida with links to various senior services and information for older adults in Florida.

For more information about how you and your family can prepare for eldercare, contact us at 727-447-5845 and get your copy of our Essential Eldercare Checklist.