Showing posts with label Medicaid. Show all posts
Showing posts with label Medicaid. Show all posts

Friday, October 1, 2010

Democrats Trying to Sway Senior Voters


The Associated Press: Democrats, "running scared in an election year," are hopeful that a $250 check - to help seniors afford prescription drugs - will turn the tide of public opinion. "Democrats ... are trying to overcome older people's mistrust of the new health care law, which expands coverage for younger generations by cutting Medicare payments to hospitals and insurers. … Behind the hoopla, the reality is modest.

"The $250 check, for example, is just a fraction of what many people in the prescription coverage gap have to pay. The gap starts after Medicare beneficiaries and their insurance plan have spent $2,830 on medications. Once total spending reaches $6,440, Medicare's catastrophic coverage kicks in, and people pay only a small amount. That means the 'doughnut hole' is $3,610 this year. ... . A previous Congress, led by Republicans, came up with the idea to control costs. It's never been popular" (Alonso-Zaldivar, 8/16).

The Hill reports that administration is acting on other fronts: "Stephanie Cutter, assistant to the president for special projects, took to the White House blog Friday to lambaste Rep. Paul Ryan's proposal to turn Medicare into a voucher program. … 'Under the Ryan plan, the Medicare seniors know and trust would disappear,' Cutter writes. 'In its place, seniors would receive a voucher to buy insurance on the private market.' Ryan argues that the current system, even taking into account the healthcare reform law, is 'on course to collapse'" (Pecquet, 8/14).

In the meantime, outside groups are hoping to bolster Democrats' political fortunes.

Roll Call: "Americans United for Change is dispatching staff and resources to battleground states in what appears to be a shoestring effort to paint Republicans as seeking to destroy Social Security and Medicare. … To prove their claims that Republicans are targeting Social Security and Medicare, Democrats and activist groups like the AUFC cite Wisconsin GOP Rep. Paul Ryan's 'Roadmap for America's Future,' which proposes to overhaul the two programs to ensure they remain solvent without eating up more of the federal budget. ... Republicans contend that Democrats are trying to scare voters" (Drucker, 8/14).

The Seattle Times: In addition, advocacy groups are protesting the presence of lobbyists at the gathering this week of state insurance regulators. "Health-care-reform activists sported surgical gowns and masks as they chanted and handed out packets that offered to 'disinfect' the gathering from a 'lobbyist pandemic.' The packets included soap, a hand wipe, a clothespin and a face mask to protect against 'lobbyist lies ... lobbyist germs ... and lobbyist stench' — underscoring that emotions over health-care reform haven't entirely subsided since President Obama signed a historic reform law in March. … The protest was organized by Washington state Health Care for America Now" (


For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Sunday, September 19, 2010

What is Elder Law?


By George Dickerman

Elder Law involves the legal issues that result as a consequence of the aging process. This is a rather narrow field and can be a little confusing to some senior citizens.

Many seniors have legal problems that are similar to people in their thirties and forties; for example, wrongful termination (employment), bankruptcy, or real estate disputes. Sometimes a potential client calls an elder law attorney to obtain, for example, family law advice regarding a possible divorce. That lawyer explains that family law and divorce issues do not fall under the category of elder law. Elder law pertains to persons who, generally, are 65 years of age or older. Nearly always, the client responds by saying: "But I'm over 65 years old".

Elder law generally involves the following types of legal matters:

Elder financial abuse. Taking advantage of another person's weaker state of mind and wrongfully obtaining their money and property through undue influence, coercion and manipulation. A civil lawsuit is usually filed to recover the property fraudulently taken.

Elder physical neglect. Most often, this concerns nursing homes that fail to properly care for their elderly patients. It can also be caused by in-home caregivers or anyone who has the primary responsibility of caring for an elder.

Estate Planning. This involves the creation of trusts, wills and powers of attorney for financial matters and healthcare decision making. Although these tools should also be utilized by younger people, they are most often created for elder adults at a time when they seek to get their financial affairs in order.

Probate. The probate process enables a decedent's estate to be distributed to loved ones after death. With the proper use of trusts and wills, the probate process may not be necessary. However, if no prior estate planning was accomplished, then it may be necessary to utilize the probate court in order to complete the distribution of assets.

Conservatorships. When proper estate planning documents have not been put into place (for example, powers of attorney), then it may be necessary to establish a conservatorship over the elder's person and/or estate. Court intervention is sought to grant someone the authority to make necessary healthcare and financial decisions for the incapacitated elder.

Medicaid Planning. This area refers to the laws and regulations in most states that determine the guidelines to qualify an elder to receive government benefits to pay the high cost of long term care in a skilled nursing facility. This is a complicated area of law with the goal of having the state pay the monthly nursing home bills and, at the same time, allowing the elder and their spouse to keep as much of their assets as possible so they can pass them on to their loved ones.

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Saturday, August 21, 2010

Guardianship in Arizona: Look Closely

Guardianship in Arizona: Elder care or elder abuse?

PHOENIX - Many people move to Arizona for the weather and recreation because it's considered a haven for retirees who want to live out their golden years. But something else is happening here - something haunting.

For Clair's mom, Gloria Horrigan, it was a nightmare.

Clair said her mother was taken to a nursing home against her will and not allowed visitors, not even family.

“It's sickening...It really truly is sickening,” said Clair.

It was a struggle for Robert Brown to bring his wife, Rosemary, home.

She was also taken and within a matter of weeks, the family wasn't allowed to see her either.

What happened in both cases started in a Maricopa County Courtroom - right in front of a judge.

Both Rosemary and Gloria had health issues that made it hard on their families.

Families can't force a loved one to get help, but a guardian can.

That's why their cases ended up in probate court, which hears issues on care for vulnerable adults.

The court approved a guardian in both cases. And both times, the guardian was Sun Valley Group of Tempe.

Their website states they offer "support for client's physical, social, emotional and mental health."

As part of their service, Sun Valley Group also took care of Gloria's personal finances.

But Clair said her mom did not get proper medical treatment and her bills weren't paid. Gloria's house went into foreclosure.

“I’m physically sick from seeing what they've done to my mother. My family, my children, everyone has been affected by this,” said Clair.

Rosemary had a similar story. She was depressed and refused medical care.

Her husband Robert needed help, so he said he agreed to let Sun Valley Group take Rosemary when they promised to make sure she got treatment.

But Robert said under the company's care, she never did, so now family friend and doctor, Marge Butler, is Rosemary's guardian.

“The bills were now coming at a ferried pace,” said Marge.

In total, Marge said the family spent over a $100,000. That was for just four months of Sun Valley Group's care.

It ended when the nursing home thought Rosemary was dying. They finally allowed the family to see her.

As for Gloria, Clair said the company seemed much more interested in her mom's money than her health.

Gloria's final bill was just under $500,000 and included charges for an employee to open her mail at $75 an hour.

“They are supposed to be her guardian and are supposed to be like her parents and look out for her best interests,” said Clair.

After repeatedly being turned down for an on camera interview, The ABC15 Investigators went to Sun Valley Group's office.

They asked us to leave.
We then caught up with the owner of Sun Valley, Peter Frenette, at a county courthouse.

He was leaving a probate hearing involving fees from a different case. Even after several questions, Frenette would not comment.

The ABC15 Investigators have found more issues plaguing Sun Valley Group.

Frenette's wife, Heather, is co-owner, but she is being investigated by the Arizona nursing board.

The Maricopa County Sheriff's Organized Crime Unit is also investigating Sun Valley Group.

By state law, both investigations are secret.

We also discovered three multi-million dollar lawsuits filed this year against the company for fraud and racketeering.

Grant Goodman is the attorney for three former Sun Valley Group clients.

“It's more of a criminal enterprise,” said Goodman, “They need to be prosecuted.”

He claimed to find a pattern with these cases.

“They effectively medicate them to such an extent that they really are non-functional,” said Goodman, “And they do that while they're liquidating their assets.”

The three lawsuits also blame probate court.

“The mob isn't this efficient, nor does the mob have the luxury of having a court rubberstamp these proceedings,” said Goodman.

Goodman is not the only one who thinks that way.

Last month, the Arizona Supreme Court issued an Administrative Order to investigate probate court. One of the issues is regulating fees.

Now, Rosemary is back with her family and doing well. She is getting the treatment that she needs.

“We just plan to enjoy life,” said Robert.

Sun Valley Group filed motions to dismiss with the three lawsuits shown in this investigation.

Neither Gloria nor Rosemary has filed a lawsuit.

If you would like any further information on guardianship, visit one or more of these websites:

National Guardianship Association offers a Model Code of Ethics, Standards of Practice and answers to basic questions 877-326-5992.

Center for Guardianship Certification has a directory of certified guardians who have taken a test, agreed to abide by ethical standards, and not been disqualified for prior conduct.

For in-depth reports on guardianship, visit AARP’s Public Policy Institute, or the American Bar Association’s Commission on the Law and Aging

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Thursday, July 29, 2010

Baby Boomers In The Role Of Caregiver


Except for the years when my father was serving in World War II, my parents were inseparable during their 54-year marriage. Then, 14 years ago, Dad died at the age of 80 of a brain tumor.

My mother, who was just 73 at the time, was pretty much self-sufficient for about a decade after that. She still played tennis, drove her car, and got together with friends and neighbors, including fellow retirees from her years as a kindergarten teacher who met monthly for lunch. After a few years, Mom had a new romantic partner as well.

Then, about four years ago, my sister and I got “the call.” It was the call to which many baby boomers who have an aging parent can relate. Who makes the call can vary. It can come in many forms -- a phone call, a letter, an e-mail, or even someone making a comment. It is that defining moment, that “wake up call” if you will, the one where you can no longer deny that your parent needs help.

Whether the call is from a physician, a sibling, a spouse or romantic partner, a friend, a neighbor or, in some cases, from the police or even the fire department, it is that call that distinguishes the moment when you go from being an adult child to someone who will now have to be the parent to your parent.

Giving Up the Car
For many of us, the first big change in our parents’ independence occurs when it becomes prudent for him or her to stop driving. (See, “Seniors in More Severe Auto Crashes Than Younger Drivers” which reports on a study conducted at Kansas State that analyzed the driving patterns of those aged 65 and over.

Parents who live in an urban setting, where driving was rarely an issue, may find it has become more difficult for them to take public transportation because of diminished mobility or increased feelings of insecurity around strangers. It is often left to the Boomer to help his or her parents to get around. And that’s just the beginning.

Seek Out Help
If you find yourself becoming your parents’ caregiver, it may be useful to invest some time and money in meeting with an eldercare or geriatric manager or counselor. They can guide your parent or you through the world of senior care that you and your parent or parents are now entering.

Linda A. Ziac, president of the Caregiver Resource Center, has been working in the eldercare field for 35 years. She emphasizes that “no two situations are the same.” Ziac gets calls from adult children who are trying to get things in place but their parent refuses to talk about it, as well as “calls from seniors from 60 to 90 saying that they want to explore help for themselves.”

You can find a local eldercare manager or counselor the same way you would find any trusted professional: ask friends, your own physician, or senior services in your own or your parents’ community for referrals. Then perform due diligence checking out their credentials, testimonials, or websites. Usually there is an initial consultation for a fee and if additional services are requested, you would negotiate with the eldercare specialist what assistance will be needed and what it will cost.

Becoming Your Parents’ Advocate
One of the best gifts you can give to your aging parent or parents is to become their advocate. This is especially important if a parent starts to have a diminished capacity and can no longer deal with such everyday activities as walking, feeding or dressing oneself, making phone calls, or cooking.

As eldercare counselor Ziac points out, there is a big difference between being your parents’ advocate and helping and taking over in a way that makes the parent feel worse. Ziac says, “There has to be a conversation between the senior and the family to honor the wishes of the senior. They can’t just come in and dictate what the right thing is to do.”

Even if the final decision about what your parent wants to do is up to him or her, you can still help by doing some research. For example, if your parent has vision challenges such as macular degeneration, you can explore if there are free services for the visually impaired in your community. Volunteers may be available to read to your parent on a regular basis for one to two hours a week.

As long as your parent is still self-sufficient and able to get to the programs and participate in activities, or has a caregiver to help out as needed, you can explore senior centers in your parents’ community to see what she or he might want to participate in.

Getting a Geriatric Assessment
If you suspect that your parent has Alzheimer’s or another kind of dementia, you might want to get a detailed geriatric assessment through a hospital or a neurologist. This will give you a starting point of how your parent is currently functioning as well as suggestions about what medical or social services your parent would benefit from. One such program is run by the Center for Healthy Aging at Greenwich Hospital in Greenwich, Connecticut.

The assessment is conducted by the Geriatric Health Team which consists of a geriatrician, who is a physician, board certified in geriatric medicine, a geriatric nurse practitioner, a pharmacist, a gerontologist, and a social services liaison. (Your parent would first be seen and evaluated by an internist who would make the determination that your parent should be referred to a neurologist or geriatric assessment center.)

Housing and Caregiver Considerations
Author Mike Campbell has spent more than 18 years in the senior housing and care industry including visiting hundreds of nursing homes or assistant living residences on behalf of his former employers. He also comes to this topic from a personal perspective. Campbell and his siblings, all of whom live in Ohio, and his mother, who is 81 and living in Florida, are deciding where she should live since her second husband died. (Campbell’s father died suddenly at age 57 of a heart attack.)

In his book, When Mom and Dad Need Help, Campbell identifies nine basic housing options that seniors and their Boomer children need to consider:

(1) parents moving in and living with you;
(2) adult day services, a community-based option, with your parent still living in their same home;
(3) home care services, while still in the same home;
(4) moving to an independent community with supportive services;
(5) assisted living communities;
(6) stand-alone Alzheimer’s dementia communities;
(7) nursing care facilities;
(8) Continuing Care Retirement Communities (CCRCs)which offer all of these levels of care on one single campus; and
(9) hospice, the final option.

Campbell says there are pluses and minuses for each option. One concern is cost but another key factor is the staff. According to Campbell, “You want to have “adequate staff and adequate training.”

In assisted living and nursing care residences, the recommended maximum staff to resident ratio varies depending upon the shift. For the morning (7 a.m. to 3 p.m.) shift, Campbell suggests that the maximum assisted living ratio should be 10 residents to one direct care staff. In a nursing home, Campbell’s maximum recommended ratio is 5 direct care staff to one resident.

In addition to finding out the staffing ratio, you and your parent will also want to tour any residences that your parent is considering. Here are some questions you want answered:

• What is the ambiance of the residence?
• Are activity rooms in use?
• What is the dining area like?
• Is the food up to the standards that you and your parent were expecting?
• What will this residential option cost?
• Are there any additional fees beyond the daily room rate and meal charges that you should know about such as charges for various types of assistance, from administering medications to escorting to meals or activities, as well as any one-time or recurring activity fees?
• How long is the lease and what, if anything is the obligation for payment of the monthly rent if there is an extended hospitalization or death that requires breaking the lease?
• How friendly are the staff and fellow residents?
• Is there an emergency system in place if your parent falls and can’t get to the phone such as pull cords in the apartments that connect to the front desk or to 911?

Legal Issues
Hopefully your parents will have already taken care of the major legal issues such as having an irrevocable or revocable trust, a will, a durable power of attorney, and a health care directive. (See “A Legal Wake Up Call for Boomers” for a discussion of these key legal concerns.) You should look at these legal and estate issues from your parents’ perspective. It may be helpful to consult with the family attorney or an elder care attorney on these matters.

As Carolyn L. Rosenblatt, who was a nurse for 10 years, a lawyer for 30 years, and who is now an elder care advisor and author of The Boomer’s Guide to Aging Parents, says, “Everyone needs to have a durable power of attorney for finances and a health care directive for health.”

Everyone Ages Differently, On Their Own Timetable
At the assisted living residence where Mom now lives, there is a petite healthy woman who is 103 years old. Everyone points to that woman as a role model of aging. On the one hand, it is very comforting to know that someone could be 103 and still be in excellent shape, walking on her own, and needing minimal assistance with everyday self-care.

But, on the other hand, it is a false standard by which all others are compared. For one thing I have learned most about aging is that there is a very wide disparity in how or when someone loses their mobility, develops dementia, suffers from chronic pain, arthritis, or contracts life threatening diseases like heart disease or cancer. Therefore, it’s important to keep the focus on the abilities and challenges of each senior rather than making him or her feel unfairly compared to someone else who seems to be faring much better even at a more advanced chronological age.

I have also learned that seniors deal with the changes they are going through in unique ways. Some become very angry and resentful, looking back at the way things were; others are accepting and positive. Excessive and ongoing depression and sadness in seniors, however, is not necessarily a normal part of aging; it is treatable. If your parent is showing signs of chronic depression, seek out a geriatric social worker or counselor, psychologist, or psychiatrist for help. (See “Depression Not a Normal Part of Aging” by Fred Cicetti).

Meeting Your Aging Parents’ New Relationships
As your parents’ life changes, they may also be forming new friendships or even romantic relationships, which may be an adjustment for you. For example, 49-year-old Brenda, whose mother died suddenly in 2008 after 51 years of marriage, said it was a challenge dealing with a new stepmother for her and her siblings.

“It wasn’t a few weeks before my father was looking for a new wife,” said Brenda, “and he was quite open about his desires, even before my mother’s funeral. He did not want to be alone and he was going to make sure that was not the case for the rest of his life. Within five months, he was online dating, and he quickly found someone who looked exactly like my mother. It was comforting and disturbing all at the same time. Within 17 months, he was remarried. All has gone well with the marriage, however a couple of my siblings have had great difficulty with the transition to having a stepmother.”

Health Care Issues
Coping with the myriad of healthcare issues is a large part of the aging process and can take a lot of time and attention. Although some parents will be fit and self-sufficient even into their 90s or beyond, others will have one or more health concerns that require your time.

With the advancement in medicine today, conditions that seemed a part of aging that just had to be endured are now treatable even if not curable. For example, there are medications that internists can prescribe for incontinence; urologists may even have additional treatment suggestions including surgical procedures, to minimize or eliminate this as a health care issue. Research advances in treating any number of age-related health care problems, such as macular degeneration, dementia, arthritis, depression, or hearing loss. You may also want to find local or even out-of-state experts who can help.

How Are They Going to Pay?
As elder care advisor and lawyer Rosenblatt points out, “One of the biggest problems we have as Boomers is that many parents did not plan on living this long and have outlived their money.” That leaves the question, how is your parent going to pay for their care?

You may want to hire an elder care attorney or specialist with whom you can have a family meeting to weigh the various options. If your parents got long term care insurance in their 50s or 60s, that is one possible option; if they are already in their 70s or 80s or older, it is probably too late to buy such insurance. Since your parents are over 65, they will have Medicare, but Medicare may not pick up all the healthcare expenses.

Your parent might want to look into the feasibility of buying “gap” insurance which covers some or all of the difference between what healthcare costs are reimbursed by Medicare and the actual costs. (Because of the recently-passed health care reform bill, you may want to check with an elder care expert about what is changing for senior healthcare.)

If your parent needs to go into a nursing home, or if you need a nurse to care for your parent in his or her home, you might want to find out if your parent is eligible for Medicaid to cover some or all of the costs. Since this is an extensive requirement and application process that varies from state to state, you might want to hire an elder care attorney to help your parent with this.

Acceptance and Perspective
Recently I asked my mother, who now needs continual care since she has mobility, vision, and memory issues, if her situation is hard on her. “No,” she answered, much to my surprise. “That’s good to hear,” I replied with relief. Then she continued, with absolute clarity and certainty, “It makes me feel loved.”

I learned so much in that exchange with my mother. I was looking at her situation as an outsider rather than as the one who has resigned herself to the walking and memory challenges that are part of my mother’s new world. I also did not understand that she views her situation from a very different perspective than I do. I am a “young” 61-year-old. My mother’s world is now mostly made up of other seniors with physical and mental challenges of their own who are in their 70s, 80s, 90s, and beyond.

Caring For Ourselves
We Boomers also have to remember that it’s okay to turn to other family members, romantic partners, friends, or even local support groups if we need help in our caregiver role. (See “Managing the Stress: Tips for the Caregiver” at the AARP website.

It Will Never Happen To Me!
I try hard to make time for Mom by visiting her regularly and calling often. I like to think that I won’t be so dependent on my children when I am that age. Not me! I jokingly tell my sons, who are now ages 20 and 24, that when their father and I are in our late 80s, we’ll be traveling around the world in a hot air balloon, joyfully independent and healthy.

However, deep down inside I can hear a little voice telling me that my mother and every other senior dealing with the tough physical and mental challenges of growing old probably had that same dream and hope when they were my age. It is a reminder to live our dreams as fully as possible while we still can because aging and all that entails is happening to all of us.

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Tuesday, July 27, 2010

PELOSI: GOP Used Fear 2 Fight Healthcare Reform


Pelosi: GOP used fear to turn elderly against health care bill

House Speaker Nancy Pelosi said Monday that Republicans used a ‘campaign of fear’ to get senior citizens to oppose health care reform.
(CNN) – Republicans used a "campaign of fear" based on false information to get senior citizens to oppose health care reform, House Speaker Nancy Pelosi said Monday.

In response to questions at a news conference in her home district in San Francisco, California, Pelosi accused Republicans of spreading misinformation against Democratic health care legislation backed by President Barack Obama, who made the issue his top domestic priority.

"There was a campaign of fear that was launched (at senior citizens) as soon as the president was elected," Pelosi said.

The reform plan includes cutting the costs of Medicare, the government-run health plan for seniors, by about $500 billion.


During months of debate on the health care bill signed into law last week by Obama, Republicans repeatedly said it was impossible to cut Medicare costs by such a large amount without reducing benefits.

Obama and Democrats say the Medicare cuts involve eliminating wasteful spending and fraud.

On Monday, Pelosi called the Medicare cost reductions "essential" to health care reform, and said Republican claims the bill would cut benefits for the elderly are "truly false."

Polls show the American public remains sharply divided over the health care issue. Pelosi said she believes polls in coming months will show more support for the bill as the public learns more about it.

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Sunday, July 18, 2010

Adult Day Care: We Really Need It



Adult Day Programs: A Reprieve for Families and the Elderly
By PAULA SPAN
The other morning, I stopped by Senior Care, an adult day program near my home in Montclair, N.J. Things were hopping, as usual.

In one room, a self-defense instructor was showing participants how to throw a would-be mugger off balance. “I want you to put the cane around my leg and pull,” he urged — and one by one, with a few self-conscious giggles, his elderly students did. “Pull hard. Just like that! One more time.”

A few doors down, a dozen people were drawing with pastels in the crafts room. The walkers in the Mile Around Club were beginning their third circuit along the building’s hallways. In the dining room, meanwhile, workers were setting up a hot meat loaf lunch.

Though almost 4,000 such programs around the country serve older adults who are frail, isolated, chronically ill or demented, I still think these adult day centers constitute one of the better-kept secrets in elder care.

People who might otherwise sit home alone with the remote, or who might move into a facility because they can’t stay home alone, instead spend several days a week being active, social, stimulated, well nourished and — at health-oriented adult day programs like this one — monitored by nurses. At the end of the day, though, the participants go home to familiar surroundings, and the centers often provide the vans that take them there.

The programs don’t come cheap, at a national average of $67 a day [pdf], but they’re dramatically less expensive than moving into assisted living or hiring home care.

I’ve heard heartfelt testimonials to their importance from weary family members trying to keep their ailing relatives out of nursing homes while also struggling to hold onto their own jobs.

“It gives me peace of mind,” said one woman whose 85-year-old mother with Parkinson’s disease goes to Senior Care three days a week. Adult day programs, the research shows, reduces caregivers’ stress. They also suffer less depression and anger, and report greater overall well-being. (Some key findings from researchers at Penn State are here [pdf].)

What’s been less clear is what adult day services do for the people who attend. A team at the University of California, San Francisco, Institute on Aging, which took the somewhat novel approach of asking the participants themselves, recently published a study in The Gerontologist showing significant benefits. “Their quality of life improved dramatically,” said the lead researcher, Eva Schmitt, now associate director of the Aging Brain Center at Hebrew SeniorLife in greater Boston.

The researchers measured how participants assessed their health and social functioning when they first enrolled in programs around the Bay Area, then again six months later and a year later, compared with a control group.

Because participants typically have multiple chronic conditions, Dr. Schmitt said, “We can’t necessarily assume their health will improve over time.” Instead, this study of 57 people (average age: 77) focused on how well people thought they coped with their limitations and whether their quality of life improved despite them.

The answer from participants, who attended at least two days a week, was clear. “They felt the impact of their dysfunctions, physical and emotional, was lower when they attended adult day,” Dr. Schmitt said. (Some other aspects of their lives were not affected.) “In the control group, people actually felt the impact of their problems on their lives increased.”

It’s a small but important study — and a timely one. Adult day programs across the country rely heavily on funding from county, state and federal governments, and on grants from local charities and social service agencies. At the nonprofit Senior Care in Montclair, for instance, nearly 70 percent of participants receive some kind of financial assistance.

All these funding sources are shrinking as government revenues and private endowments plummet. Adult day centers in many states are limiting attendance days or cutting enrollment; a few have closed their doors altogether. Senior Care, running a deficit, first tried to sell the airy facility it built just five years ago. That didn’t happen, so the program is being acquired by a for-profit health care company.

“About 20 percent of the seniors we care for will have to find alternative sources of financial aid,” said Emma Justice, Senior Care’s beleaguered marketing director.

Dr. Schmitt said, “I hope very acutely that our findings will help convince lawmakers not to make big cuts in adult day services.”

Well, that would be nice. A couple of years ago, adult day directors probably would have said their biggest problem was letting families know that they existed, that they could accommodate old people (and sometimes, younger disabled adults) with many kinds of physical and cognitive problems, and that they could often come up with grants to lower the costs.

Now, despite mounting evidence that they help those on both sides of the caregiving equation, they’re just trying to stay afloat.

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Wednesday, July 14, 2010

Five Ways to Care For Your Elderly Parents


Few people gleefully anticipate the task of caring for an aging parent — but plenty seem to deny that it's coming. Haven't you felt like that? Sooner or later, avoidance can thrust adult children into the caregiver role with a shotgun start.

A parent's slip in the bathroom or a collision caused by a mistake in the driver's seat can precipitate a deluge of anguished decisions and rapid changes you're not ready to handle. Suddenly, you could be scrambling to locate account numbers to pay Mom's bills while she's in the hospital, tangling with her insurance company to figure out why coverage for an X-ray was denied, and consulting with your brother—who lives at the other side of the country—about getting Mom into an assisted-living facility. Hasn't she taken care of us for all those years? Why can't we do the same?

You grapple with guilt because your mother never wanted to move out of her home, but now her condition leaves little choice. As the drama plays out, you're also trying to stay afloat at work and look after your other dependents, the kids.

The first step toward avoiding such baptism by fire is to acknowledge you'll most likely take on caregiving responsibilities someday. According to the Family Caregiver Alliance, the number of "unpaid family caregivers" is set to reach 37 million by 2050, an 85 percent increase from the year 2000. You can help your parents stay happily independent as long as possible if you start those tough conversations now and do some thorough preparation. Here's a game plan.

The vast majority of senior citizens want to live out their days in their own homes—and without being a burden on their kids. Planning ahead greatly raises your odds of making it happen.

1. Consider hiring a pro. A knowledgeable, neutral professional can assist from the start, even when your parents are still living at home. Locate an expert through the internet to help navigate everything from finding a companion service for Dad to identifying a mediator to help settle family differences over caregiving choices. "You may think you can handle it yourself, but you can't—not when you're so [emotionally] close to the situation," says Don Terrell of Ellensburg, Wash., who got help from a geriatric care manager later in the process when his family sought a facility for his mom, who has Alzheimer's disease. According to NAPGCM, an initial assessment runs $300 to $800, and services cost $80 to $200 per hour, depending on where they're needed.

2. Keep track with technology. Helping your parents remain in their home may be realistic but typically requires at least a few adjustments to keep them comfortable and safe. Savvy families are deploying products like QuietCare, which relies on strategically placed motion sensors, to keep tabs on their elders. Phyllis Baker's 80-year-old father lives alone outside Detroit, nearly five hours away from her home. But she needs only to check her iPhone to allay worries, she says, like "Has he gotten out of bed? Is he in the bathroom and never came out?" No cameras or microphones are involved, so her dad has privacy, and a secure website updates a status report every two hours. QuietCare calls immediately if anything is out of the ordinary. Inspired by her two sons, marines regularly deployed overseas, Baker is considering another tech boost: webcams for "virtual meals" together.

3. Remove booby traps. The National Association of Home Builders has certified aging-in-place specialists who can consult and make structural changes. Extras that you or a specialist might install, says Meri-K Appy of the Home Safety Council, include antiscald devices for showers and faucets (like H2O Stop, a new product) that protect older skin, which is quick to sustain serious burns; alternatively, set water heaters to "low" or at 120 degrees. Carbon monoxide detectors are recommended since elderly people are sensitive to even low concentrations of the deadly gas. Special smoke detectors with strobe lighting or a vibrate feature can wake them up when conventional devices wouldn't—new research suggests the latter are set at frequencies that many elderly people can't hear. Grab bars in the shower and near the toilet are usually a must, but their often ugly appearance isn't. Moen's new SecureMount options are an improvement on institutional-looking models, says Appy, and they don't require tearing down tiles.

4. Visit frequently. The time together matters, plus you'll have a better sense of whether they're safe, mentally sound, and in the best living situation, says Alexis Abramson, author ofThe Caregiver's Survival Handbook. Keep an eye out for subtle changes: Are the plants watered? Is unopened mail piling up? Do they have bruises suggesting they may have fallen? Enlist your family and your parents' trusted neighbors to check in.

5. Anticipate expenses. To help maintain your parents' independence and health, you'll very likely need to pay for a few services. The national average for a home healthcare aide to assist with hygiene and medication, say, is $19 per hour, according to a MetLife Mature Market Institute analysis. Think Medicare will pay? Not if they need the aide for a chronic condition. "I dispel this myth all the time."Adult day care" averages $61 per day, according to MetLife. Lisa Midden got financial assistance for her 88-year-old dad through a Florida state Medicaid waiver and a local grant, but he must requalify each year. "Until we learned about these [benefits], everything was coming out of our pocket," says Midden, whose father lives with her and her husband in Orlando. A few afternoons at adult day care and several hours from a nurse's aide are covered each week, plus the Middens get 12 weekly hours of "respite care." Start with your local Area Agency on Aging

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Sunday, July 4, 2010

Health Care Reform & Medicare


Health Care Reform and Medicare Recipients
Source: Saint Joseph's University

From the time presidential candidate Theodore Roosevelt first discussed health care reform in 1912, the topic has been a precedent-setting issue in the U.S. The 2010 passage of health care legislation is no different, but has many Americans in a quandary about how it will affect them. This is especially true of senior citizens.

Seniors, who generally are on fixed budgets and have increased medical needs, have a high stake in health care reform. But unfortunately, the rumors swirling about this topic are as sizeable as the 1,000 pages of legislation. George Sillup, Ph.D., associate professor of pharmaceutical marketing at Saint Joseph’s University in Philadelphia, offers clarification on the issues most relevant to this population.

Impact on Medicare — A Mixed Bag
Beginning next year, annual wellness visits and certain preventive services such as cancer screenings, will be free of cost. Medicare beneficiaries will no longer have to pay deductibles and co-insurance for this kind of care. Eighteen months after enactment, the law says Medicare beneficiaries will have access to a comprehensive health risk assessment and a free personalized prevention plan.

Groups that advocate for seniors, including AARP and the Medicare Rights Center, say that there will be no cuts to Medicare coverage for seniors. Additionally, next year, the law provides a 10 percent bonus through Medicare to primary care doctors and general surgeons practicing where they are in short supply.

How will Medicare prescription-drug benefits change? — A Big Win for Seniors
This year, there is a $250 rebate for Medicare Part D enrollees who fall into the “doughnut hole” of drug coverage. “That’s a big improvement,” according to Sillup, “because seniors previously covered under Part D received coverage for their prescriptions up to $2,830 a year, then the participant paid 25 percent of the cost and Medicare covered the remaining 75 percent.” Once their prescriptions exceeded $2,830, they fell into the doughnut hole, or hole of no coverage, until they spent another $3,610 for their medications.

What will happen to Medicare Advantage? — Higher Premiums
Today, Medicare pays private insurers an average of 14 percent more than it spends to care for those enrolled in traditional Medicare. The overpayments help lower premiums and co-insurance costs, and provide extra benefits like vision and dental coverage, even gym memberships. The law would nearly eliminate the overpayments, saving $132 billion over the next decade.

For people currently enrolled in Medicare Advantage plans, premiums and benefits will remain the same through the end of the year according to the Centers for Medicare & Medicaid Services (CMS). But costs could increase and extras may be eliminated next year when payments to insurers are to be frozen at 2010 levels. The payments will start to drop in 2012, Premiums will likely increase next year as they did this year

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Tuesday, June 29, 2010

Westchester NY Library Helps Seniors Save


Westchester Library System Helps Seniors Save a Buck with New Senior Benefits Information Centers:

Tarrytown, NY 2010 -- Today’s struggling economy has left many older adults facing financial hardship and filled with uncertainty when it comes to their healthcare. For those on a fixed income, saving money wherever possible has become increasingly important. The Westchester Library System’s (WLS) new Senior Benefits Information Centers (SBICs), located at libraries in Mount Kisco, Shrub Oak, Tarrytown, and Yonkers, offers older adults benefits counseling covering a broad range of topics including Medicare health and prescription plans, food stamps, HEAP, EPIC, weatherization, minor home repair, and tax relief programs.

WLS has partnered with the Medicare Rights Center and Westchester County’s Department of Senior Programs and Services to make the free one-on-one counseling available at four Westchester locations. SBICs are now open at the John C. Hart Memorial Library in Shrub Oak (Tuesdays and Wednesdays from 10am to 1pm) and the Grinton I. Will Library in Yonkers (Mondays and Tuesdays from 10am to 1pm; Thursdays from 11am to 1pm). Grand openings are scheduled for The Warner Library in Tarrytown on April 21, 2010 and Mount Kisco Public Library on May 12, 2010. Counseling at both locations will be available on Wednesdays from 10am to 1pm.

“In this economy, everyone needs to save a buck – especially seniors,” said Robin Osborne, Director of WLS’s Office of Community Connections. “WLS’s SBICs help Westchester’s older adults hone in on the specific programs that qualify for – whether it’s related to healthcare, home care, or tax relief. Seniors receive one-on-one attention to have their questions answered and leave armed with the information they need to save.”

SBIC’s counselors address each visitor’s specific needs and guide them through a variety of online resources to identify their individual eligibility. All locations are equipped with a dedicated phone line to answer questions as well as computers and printers that enable seniors to leave with the appropriate information and referrals. In an effort to make SBIC services available to an even greater number of seniors, WLS is also exploring the possibility of expanding the program to other libraries in Westchester County.

Ann Acken, a senior citizen from Somers, recently visited the SBIC at the John C. Hart Memorial Library in Shrub Oak with questions about her Medicare coverage. "My experience was very enlightening. The volunteer counselor, Marna, was very patient and answered all of my questions."

Volunteer SBIC counselors are trained by the Medicare Rights Center and include retired professionals such as nurses, teachers, social workers. WLS and the Medicare Rights Center are seeking additional volunteers, particularly in the Northern Westchester area. Westchester residents who are interested should be at least 50 years old with excellent public speaking and interpersonal skills, be computer literate, and able to commit to a minimum of 12 hours per month. Some knowledge of the health care system and fluency in Spanish is a plus.

“The SBIC counseling program is especially important this year because many people are not aware of their eligibility for Medicare Savings Programs and savings available through other public benefits, such as Food Stamps,” said Lois Steinberg, Westchester Program Director for the Medicare Rights Center. “Our trained counselors can help them find the benefits they are eligible for and show them how to apply.”

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Wednesday, June 16, 2010

New Jersey Budget Cuts Affect Seniors


Assembly Democrats rap Senior Services budget cuts

Democratic legislators had harsh words for Gov. Christie's proposed budget on health and senior services Monday, arguing that while the governor had called for "shared sacrifice," his budget would seriously hurt the elderly and other vulnerable citizens.
At the Assembly Budget Committee's 31/2-hour hearing on the Department of Health and Senior Services, Commissioner Poonam Alaigh said the budget decisions had been difficult, but she defended the administration's proposals. Even with 6 percent funding cuts to the department, she said, the budget preserves the core mission of the department, including protecting public health.

Funding for hospital charity care would increase under the budget, she said, along with funding to help seniors remain in home and community-based programs as a cost-effective alternative to nursing-home care.

And Alaigh said that even with the proposed changes, New Jersey would continue to offer among the best health benefits nationwide.

Democratic lawmakers disagreed.

"I don't understand our race to mediocrity," said committee Chairman Louis Greenwald (D., Camden), speaking about proposed changes to New Jersey's low-cost prescription programs for lower-income elderly residents, Pharmaceutical Assistance for the Aged and Disabled and Senior Gold. "This is a program that New Jersey should be proud of."

Legislators said they particularly disliked a proposal to add a $310 annual deductible for the prescription-drug programs and to increase co-payments for brand-name prescriptions from $7 to $15. Co-payments for generic drugs would drop from $6 to $5.

Greenwald predicted that with the increased costs, "we'll see senior citizens rationing drugs, getting sicker, and ending up in emergency rooms and nursing homes for expensive treatment that will cost taxpayers even more."

Assembly Appropriations Chairwoman Nellie Pou (D., Passaic) was one of several lawmakers who noted that increased health-care costs would come on top of cuts to property-tax relief.

"We're talking here about our parents, grandparents, and the cornerstones of our communities who will be out $1,725 in lost property-tax relief and increased prescription-drug fees as people making $500,000 enjoy a $1,630 tax break," Pou said.

Others on the panel echoed those sentiments. "Senior citizens in communities throughout our state are going to feel the sting of this budget while the wealthiest residents enjoy their tax cut," said Assemblyman Albert Coutinho (D., Essex).

Assembly Republican Budget Officer Joseph R. Malone III, of Burlington County, hinted that Christie's proposals were not very different from those offered in previous years by other governors, including Democrats.

"Have you heard about co-pays in the past?" Malone asked Alaigh. "Have you heard about pretty much everything you've heard about today?"

Medicaid co-payments are frequently proposed by New Jersey governors in budget proposals, typically to be dropped by the Legislature under pressure from advocacy groups.

Last year, Gov. Jon S. Corzine called for more than 400,000 low-income residents receiving Medicaid assistance to pay up to $10 a month for prescription drugs. The co-payments were eliminated in the final budget.

"This is the beginning of a process in which I think all of us are going to try to work with you to mitigate any damages done by these suggested cuts," Malone said.

The budget committee also met with Department of Environmental Protection Commissioner Bob Martin yesterday to discuss his department's proposal.


For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524

Friday, May 21, 2010

Elder Americans Need to Watch Florida Lawmakers


The St. Petersburg Times reports:

Elderly Floridians who want to stay out of nursing homes would be forced into managed care under two bills passed this week by the House in an effort to pare Medicaid costs.

But the Legislature's own policy analysts suggest that managed care may actually be more expensive for frail older people, based on the current track record of HMOs.

A recent report examined a managed care program that provides home health care, housekeeping and many other at-home services, as well as assisted living when necessary. It did keep people out of nursing homes but was more expensive than two traditional programs, run by not for profit agencies, that cover the same services.

The state could save money by beefing up the traditional programs, the analysts said. The House bills would do just the opposite -- wiping out the traditional programs and putting elderly clients into managed care.

``It makes no sense,'' says Margaret Lynn Duggar, director of the Florida Council on Aging, which lobbies for the not-for-profit agencies that run the traditional programs. ``Legislative leaders have been convinced that managed care will save them money when the facts do not prove that out.''

The bills surfaced just a few weeks ago, said Sen. Nan Rich, D-Sunrise, and have not been well thought out.

``It actually will have the opposite effect of what we want to happen'' in the way of savings, Rich said, ``and that's what this (analysts) report is showing.''

The bills are a product of the House Select Policy Council on Strategic and Economic Planning, chaired by incoming House Speaker Dean Cannon. He could not be reached Monday for comment. Nor could vice chair Denise Grimsley, R-Sebring.

The House bills have no companion bill in the Senate but could be passed during budget negotiations. Incoming Senate Mike Haridopolos, R-Melbourne, has made Medicaid reform ``an urgent priority'' for budget cutting. He could not be reached for comment.

Medicaid -- which provides health care to the poor -- is a huge, expanding chunk of the state budget. When it comes to younger adults and children, pilot projects have indicated that managed care might save money.

That's because those Medicaid clients go directly to their doctors and hospitals, who bill the state -- a system that sometimes results in excess services and outright fraud. Managed care companies receive a monthly stipend for each client, negotiate rates with health care providers and decide which services are really necessary.

Keeping frail, older people out of nursing homes works differently.

Clients wanting Medicaid to pay for home care or assisted living cannot pick their own services and are not entitled to care. A case manager always decides what services they need and how much it will cost.

Roughly 33,000 aged and disabled Floridians now receive these services from one of three Medicaid programs included in the analysis released in March by the Legislature's Office of Public Program Analysis and Government Responsibility.

It examined clients that entered those programs between 2005 and 2008 and calculated their total cost to Medicaid. The results for the two traditional, fee-for-service programs were:

• The Aged and Disabled Adult program, which provides at-home services like chores, respite care and home health care, cost $15,120 per client during that period, compared to $50,000 or more for a nursing home.

• The Assisted Living for the Elderly program, which pays for assisted living, cost $17,424.

• The managed care program, Nursing Home Diversion, provides both at-home and assisted living services in 30 counties cost $23,364 per client.

Average payment rates for the 16 companies that provide managed care to 14,000 clients have dropped a few thousand dollars a year since the period studied by Legislature's analysts, so these disparities would presumably be narrower today.

Still, Florida could save tens of millions of dollars a year by retaining and expanding the traditional programs instead of managed care, said Larry Polivka, a Pepper Foundation scholar in residence. He conducted similar studies of the three programs, with similar cost disparities, while running an aging research center at the University of South Florida.

``I have been in policy analysis for 25 years,'' Polivka said, ``and I have never seen clearer evidence for clear cost effectiveness of one approach over another.''

Among other things, he said, the not-for-profit agencies that run the traditional programs charge the state a few cents on the dollar for administrative overhead and benefit from volunteers.

By contrast, the state's most recent actuarial report projects that managed care companies will an average of 78 cents on the dollar on care this fiscal year, retaining 22 cents for overhead and profit.

The legislative analysis did note that the managed care program was more effective at delaying nursing home entry than the traditional programs.

But that had little fiscal impact. That's because most clients on all three programs usually live their lives out at home or in assisted living. Those few who do require a skilled nursing home are generally so incapacitated they live only a few months, so delaying their entry into the home by a few weeks does not save much money.

For more information contact Senior Solutions at (954) 456-8984 or toll free at 1-800-213-3524