When They Say No: 8 Ways to Introduce In-Home Care for Seniors

You desperately need regular breaks, but your older adult absolutely refuses an in-home caregiver. What can you do?

Seniors often won’t admit they need help, even if they’re struggling with everyday tasks. In-home care can be a sensitive subject that leads to arguments or an immediate shutdown when you bring it up.

Your older adult might see it as a waste of money, an insult to their abilities, or an invasion of privacy.

We found excellent advice from Family Caregiver Alliance with 8 ways to make the transition easier.

There are helpful tips on how to overcome this challenge and make in-home care for seniors more acceptable – even if your older adult initially said no.

Here, we highlight the key points from the article.

8 ways to ease into in-home care for seniors

1. Start slowly and allow time for them to get used to the idea
Your older adult might need time to adjust to the idea of having someone in their house.

To ease the transition, start off slowly. At first, have the aide only come a few hours each week and focus on less personal tasks.

Then, add hours and additional tasks as your older adult becomes more comfortable with the idea and that person.

2. Listen to your older adult’s fears and reasons they don’t want in-home care
Instead of shutting down objections right away, let your older adult express their feelings.

They’re more likely to cooperate when they’ve been heard and know that their opinion matters.

Understanding their concerns also helps you address those fears. Even better, involve them in the hiring process so they can help choose the person who will be caring for them.

3. Help them retain dignity by saying it’s for you, not them
If you present the idea of in-home care as something that helps you rather than them, seniors might be more receptive.

That way they’re less likely to feel that they’re losing independence or aren’t capable.

4. Use the doctor’s authority and say that it’s a prescribed service
Many older adults respect authority figures like doctors and may be more willing to accept home care if they think the doctor has prescribed it.

Tell them that’s what the doctor said, create a fake “prescription,” or ask the doctor’s office for an “official” note on their stationery – whatever works best.

5. Use housekeeping needs as an excuse
Pretending that you need help with housekeeping and other chores is another way to ease an in-home caregiver into the house.

That makes it seem like it’s about your needs rather than theirs.

6. Pretend that it’s a free service
If your older adult isn’t directly paying for in-home care, you could pretend that it’s free.

That makes it more likely that they’ll be open to it since they’ll be taking advantage of a free service.

7. Introduce the caregiver as a friend
Another approach is to introduce the in-home caregiver as a friend of yours who needs some company.

That takes away the stigma of needing help and helps them trust the caregiver.

8. Tell them it’s a temporary arrangement
It may be more acceptable to start using in-home care if your older adult thinks it’s only temporary.

Once the in-home caregiver becomes a part of their routine and they adjust to the idea, it’ll be easier to continue using the services.

-DailyCaring.com

https://dailycaring.com/when-they-say-no-8-ways-to-introduce-in-home-care-for-seniors/?utm_source=DailyCaring&utm_campaign=e6452230a9-DC_Email_2019-05-07&utm_medium=email&utm_term=0_57c250b62e-e6452230a9-123358125

Which End-of-Life Form is Needed? POLST vs DNR

POLST vs DNR: they’re two different end-of-life forms.

If your older adult knows how they want to be treated during a health emergency, it’s essential to consider two important documents – a POLST and a DNR.

Both documents are available for free and ensure that your older adult’s wishes for end-of-life treatment are respected by emergency responders and hospitals. But there are some key differences.

To help you and your older adult choose the form that works best for them, we explain what a POLST and a DNR are, differences between them, why they’re necessary, and where to get the forms.

What is a POLST?

POLST stands for Physician Orders for Life-Sustaining Treatment. It’s a one page form that specifies the end-of-life treatments that someone does or doesn’t want.

It’s legally recognized in many, but not all, U.S. states and is usually printed on bright pink paper to make it easy for emergency responders to find.

A POLST is a medical order signed by a doctor, so if your older adult stops breathing or their heart stops beating, emergency responders and hospitals must follow the POLST’s instructions.

This document is usually recommended for terminally ill or very frail seniors who have made their end-of-life wishes clear.

What is a DNR?

DNR stands for Do Not Resuscitate and is a signed medical order written by a doctor.

It tells health care providers and emergency medical personnel not to do CPR on your older adult if they stop breathing or if their heart stops beating.

The DNR is only a decision about CPR (cardiopulmonary resuscitation).

It doesn’t affect any other treatments, such as pain medicine, other medicines, or nutrition.

For doctor’s orders about other end-of-life treatments, your older adult may want a POLST instead.

POLST vs DNR: the most important difference

The primary difference between and POLST and DNR is that a POLST covers a variety of end-of-life treatments. A DNR only gives instructions about CPR.

With a POLST, seniors can specify:

  • If they do or don’t want CPR
  • What type of life-prolonging medical interventions they’d want on top of comfort care, if any
  • Under what circumstances they would want to be moved to a hospital
  • If they would want a feeding tube and if so, for how long

With only a DNR, during an emergency, decisions about other interventions or treatments beyond CPR would be left to emergency responders or hospitals.

Why would seniors need a POLST or a DNR?

Without a DNR or POLST, hospitals and EMTs are required to do their best to resuscitate someone who is not breathing or doesn’t have a heartbeat.

They can’t stop these efforts without a signed medical order.

So, if your older adult doesn’t want those measures to be taken, they must have either a POLST or DNR.

How to get a POLST or DNR

After understanding your older adult’s preferences, discuss their end-of-life preferences with their doctor.

Doctors should have access to the appropriate state forms for POLST or DNR — and they must sign the form to make it official. It’s essential to use a form that’s legally recognized in your older adult’s state.

But no matter which forms are legally recognized, it’s important to discuss your older adult’s end-of-life preferences with their doctor. They can advise you on how to ensure those wishes will be carried out.

Make sure the DNR is easily accessible

A POLST or DNR can only be honored if people know it exists.

Notify doctors, nurses, caregivers, family members, and assisted living staff about your older adult’s wishes and that they have a signed POLST or DNR.

Make sure doctors, hospitals, and assisted living communities have the form on file and/or post it prominently in your senior’s room.

Print copies on neon colored paper for your hospital essentials kit and for family members.

At home, make sure the form is posted prominently near your older adult’s bed or on the refrigerator – EMTs are likely to look there.

-DailyCaring.com

https://dailycaring.com/which-end-of-life-form-is-needed-polst-vs-dnr/?utm_source=DailyCaring&utm_campaign=b30a4c145f-DC_Email_2019-05-09&utm_medium=email&utm_term=0_57c250b62e-b30a4c145f-123358125

Tips on Having “The Talk” with Aging Parents

Open communication between parents and children about financial, estate and long-term care planning matters benefits the family on a number of levels.  From a practical perspective, a parent’s wishes are more likely to be carried out correctly and expeditiously upon disability or death if he or she has shared knowledge about the location of estate planning and financial documentation with the child named as fiduciary.

Some parents discuss their financial and estate-planning affairs readily with adult children while others clam up about the subject. So long as the parent retains capacity, the right to privacy and independence in personal and financial lives remains intact.

However, as parents age, children left in the dark are often concerned about whether their parents have made any plans at all – yet, may be reluctant to raise the issue. The following suggestions are designed to assist in starting “the conversation”:

  1. Broach the topic while health and personal issues are stable. Decisions made after the onset of illness, crises or even in the midst of transitional stages may be emotionally based and thus not well analyzed. Also, procrastination can effectively limit available options. A decline in health or death of a friend or family member often opens the door to a planning discussion.
  2. No adult wants to feel a loss of financial control and some parents may need reassurance that they remain in the “driver’s seat” even after completion of the planning process. Emphasizing that a confidential relationship exists between them and their chosen advisors and planners demonstrates a child’s respect for privacy and independence. (Naturally, the approach differs where a parent is unable to manage his or her own affairs.)
  3. Before an adult child approaches aging parents about estate and elder law issues, his or her own planning should be completed or at least underway. Striking up a conversation about the child’s progress in establishing a plan is a natural segue into  a chat about the parents‘ status in that regard. In addition, seminars offered by attorneys focusing on estate planning and elder law will normally prove informative and attendance can be turned into a family outing.

 

Example: Marilyn is concerned that her parents (in their late 70s) may not have prepared an estate plan. Instead of bringing the topic up directly, she informs her mom and dad about a seminar being offered by a local estate planning/elder law attorney. She invites them to accompany Marilyn and her husband to the session, as they haven’t yet done their own planning. Subsequent discussions about the parent’s affairs may become more comfortable since the subject has now been raised and accurate information has been collected. Such seminars have spurred many into beginning or updating their estate plan.

 

  1. Holding a family meeting to discuss these issues can be effective – depending on family dynamics. All too often, the family begins collaborating only after a parent’s health has suffered a serious decline and the conversation centers around allocation of responsibility for the parents’ needs. An agenda (ideally structured with input from all family members) should be distributed ahead of time so that everyone is prepared, and nobody is surprised. It is generally wise to limit attendance at the initial meeting to immediate family members.  Including in laws may not be productive unless they are truly “like family” and everyone agrees that they belong.
  2. Last (and by no means least), even seasoned estate planning practitioners should not draft documents for relatives. If any family member feels slighted or is dissatisfied with the services, underlying or even overt resentments may develop. Besides, the lawyer (who was just trying to help out) has usually not been compensated, illustrating Clare Booth Luce’s famous quote: “No good deed goes unpunished.”

 

-Cynthia Sharp, Esq

Home Dementia Exercise Program Increases Abilities and Improves Symptoms

Dementia exercise programs improve cognitive symptoms

A new dementia exercise therapy program that can easily be done at home improves abilities and quality of life in seniors with Alzheimer’s or dementia.

Love to Move is a chair-based exercise program designed for seniors with dementia. It was developed by the British Gymnastics Foundation (BGF) and inspired by successful programs in Asia.

It’s been shown to improve cognitive function, reduce depression, improve balance, and improve ability to perform everyday tasks.

We explain what the Love to Move program is and how the exercises improve dementia symptoms. We also share the free instruction booklet BGF created so you can do these simple exercises with your older adult.

 

How the Love to Move program helps seniors with dementia

Experts in Japan created chair-based dementia exercise programs to improve the lives of nursing care residents with dementia. The simple exercises were based on cognitive stimulation, memory arousal, and music. The results were so positive that the program won full state funding and is now used in every care home across the country. The BGF was so inspired by the Japanese program’s success that they worked with the program leaders to design UK-based dementia exercise programs using those same principles.

BGF’s pilot program showed amazing results in seniors with dementia:

  • 71% of participants had noticeable physical improvements
  • 86% were socializing more with other residents and staff
  • 93% seemed happier and more settled
  • 100% were easier to connect with

 

Why exercises for dementia improve ability to perform everyday tasks

The Love to Move program is based on the concept of performing different movements with the right and left sides of the body at the same time. Basically, it’s like patting your head and rubbing your stomach at the same time. These types of exercises take a lot of concentration. When practiced, it increases the ability for the right and left sides of the brain to process information independently of each other. This increases the number of neural connections and increases cognitive ability. The Love to Move exercise program has increased seniors’ ability to perform everyday tasks like feeding themselves, engaging in activities, and communicating with family and friends. Coordination and ability to sit unassisted in a chair was also improved.

 

Simple at-home dementia exercise programs

The BGF created a free booklet with 4 essential home exercises from the Love to Move program so older adults everywhere can benefit from this program. It includes straightforward instructions, example photos, and special tips from head coach Kim Hall on how to make the exercises easier and more effective. Print or save the booklet and give these exercises a try with your older adult.

 

Source: https://dailycaring.com/dementia-exercise-programs-increase-abilities-and-improve-symptoms/?utm_source=DailyCaring&utm_campaign=41b883e58b-DC_Email_2019-04-08&utm_medium=email&utm_term=0_57c250b62e-41b883e58b-123358125

8 Ways to Prevent Alzheimer’s Wandering

Alzheimer’s wandering is dangerous. Getting lost or accidentally wandering away is a serious issue for people with Alzheimer’s or dementia and a major worry for caregivers. According to the Alzheimer’s Association, 6 out of 10 people with dementia will wander. It can happen at any point in the disease, even if they’ve never done it before. It might seem unbelievable that seniors who are frail, slow-moving, or use a walker could get very far without anyone noticing. But it really does happen! The scary thing is that some older adults who wander away are never found and some pass away due to accidents or exposure. That’s why it’s so important to keep your older adult safe and do your best to prevent them from wandering.

We share 8 ways to reduce wandering behavior and keep seniors safe even if they do wander.

What causes Alzheimer’s wandering?
There are many reasons why someone with Alzheimer’s might wander, including:

Fear or stress – they might not recognize where they are, the environment is overstimulating, or a loud noise or confusing situation could upset them
Basic needs – they might be looking for food, a bathroom, or just want to get some fresh air
Searching – they might get lost while looking for someone or something
Boredom – they could be looking for something to do
Old routines – they might be trying to go to work, do chores, or run errands like they used to

8 ways to prevent Alzheimer’s wandering

1. Install door and window alarms and locks
Making it difficult for someone with Alzheimer’s or dementia to get outside the house is essential to preventing wandering.

Simple home safety modifications can make it tough for them to open doors to the outside, including:

Adding childproof door knob covers (like these) make it more difficult to open doors
Installing an additional lock higher up on the door so they’re out of your older adult’s line of sight because people with dementia often don’t look above eye level – try this for regular doors and this for sliding patio doors
Installing door and window alarms (like these) to alert you if they’re opened
Using pressure-sensitive alarm mats (like this) next to their bed to alert you if they get up at night
Using an alarm like SafeWander that’s triggered when a specific threshold is crossed
Important: Be aware of fire safety needs for everyone in the house. Make sure all locks are easily accessible to people without cognitive impairment. Doors should be able to be opened quickly in case of emergency.

2. Camouflage doors that lead outside
Another way to discourage your older adult from opening doors that lead outside is to camouflage them. Often, people with dementia won’t be able to find the door if you cover it up or won’t open it if you place large signs on it. For example you could install a curtain rod above the door to hang a dark curtain or wall hanging over the door. Slide the curtain open and close as needed, taking care to not let your older adult see you do it. You could also place large signs saying “DO NOT ENTER” or “STOP” on the door. Many people with dementia won’t open a door with those types of signs.

Another effective technique is to put a large black doormat in front of the door. Seniors with dementia often think that dark areas of the floor are holes and won’t walk over them. This will discourage them from actually reaching the door.

3. Clearly mark interior doors
When they’re trying the doors leading outside, your older adult could actually be looking for an interior room, like the bathroom, kitchen, or their bedroom. Make these key rooms easier for them to find by adding large signs or pictures on these doors or leaving the bathroom light on at night.

4. Find and solve triggers for wandering behavior
Another thing to do is to identify the causes for your older adult’s wandering behavior. Make notes of when it’s happening and what they were doing or saying just before. Over time, you may discover a pattern, like they wander around the same time every day, when they’re bored, looking for the bathroom, or hungry. If wandering is caused by boredom or a physical need, find meaningful activities to keep them engaged and make sure to encourage a toilet visit or get them a snack or beverage before that time of day. Some people may be trying to return to an old routine, like going to the office in the morning or picking up a child from school in the afternoon.

To reduce this need, tell reassuring fibs. You could say that it’s a federal holiday and the office isn’t open today. Or mention that their child has a playdate at a friend’s house and the friend’s mom promised to drop them off later. Then, distract your older adult with a favorite activity or snack to take their mind off of their old routine.

Other seniors are looking for a person or object and wander because they’re searching. Think creatively to reassure them that everything is ok. You could say that the lost item is being repaired or in a safe place with a trusted friend. Or you might say that the person they’re looking for called to say they were delayed, but would be there in the afternoon or the next day. Encouraging them to tell you about the person or object often calms them down, distracts, and reduces the urge to search.

5. Enroll them in a safe return program
In case they do get out of the house, make it easier to find your lost older adult by enrolling them in a program like the Alzheimer’s Association’s MedicAlert Safe Return.

Once enrolled, your older adult will get a wearable ID that allows people and law enforcement to identify a found senior and contact you. You can also call a 24/7 toll-free support line if you need to report your older adult missing. You may also want to contact local law enforcement agencies to ask if they offer Silver Alert or similar programs that help caregivers locate missing older adults.

6. Have them wear a GPS device at all times
You might feel safer if your older adult wears a GPS tracking device at all times. A wearable GPS device like a wristband sends out tracking signals that can be followed by rescue personnel.

Some local law enforcement agencies offer locator services like SafetyNet or Project Lifesaver. If your older adult won’t tolerate a wearable tracker, consider the SmartSole. It’s a GPS tracker that’s hidden in shoe insoles.

7. Hide keys, purses, wallets

If car keys are accessible, seniors could drive off before you return from a quick bathroom break. To prevent this from happening, make sure all car keys are well-hidden and consider adding a steering wheel lock to the car.

Another precaution is to hide their purse or wallet. Some people won’t leave the house without those essentials.

8. Be prepared
Other ways to prepare just in case your older adult wanders and gets lost are to:

Snap a quick photo of them each morning. You’ll always have an up-to-date photo with the clothes they’re wearing that day in case you need to show it to law enforcement and rescue personnel.
Alert neighbors to their wandering behavior and share tips on how to distract or slow them down. Make sure all neighbors have your contact information.
Sew or iron-on ID labels with contact information into all their clothes.

Source: https://dailycaring.com/8-ways-to-prevent-alzheimers-wandering/?utm_source=DailyCaring&utm_campaign=ae126a2562-DC_Email_2019-03-25&utm_medium=email&utm_term=0_57c250b62e-ae126a2562-123358125

Homeowner and Reverse Mortgage Scams

Homeowners beware! Another potential source of financial scam is through reverse mortgage scams. Direct mail pieces, emails, even TV ads, promote that these “financial advisors” can exponentially increase the potential monetary value of your home or property. Sometimes these written pieces seem official and appear to be written “on behalf” of an official from your county, like The County Assessor.  This letter may state the assessed value of the property and give the homeowner the chance for a reassessment of not only the property value, but also the taxes associated with it. These con artists use public information and twist it through false advertising into a financial scam to get you to provide them with funds.

For more information on reverse mortgage scams, investment schemes and other types of fraud targeting the elderly, be sure to visit our Resources page to receive a free copy of our book, Senior Shakedown: The Unknown Dangers of Getting Old, and How to Protect Your Loved Ones.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Investment Scams

Many of our elderly clients have accumulated comfortable nest eggs funded by a lifetime of hard work and sacrifice. This can make them particularly vulnerable to financial predators who victimize them through sophisticated “investment” schemes that seem legitimate to the unwitting.

Our advice is to everyone, young and old alike, is to beware of doing business with people who suggest that you invest in deals that will generate a huge return on your funds in a relatively short period. Living by this precept can save you some headaches: “If it sounds too good to be true, it probably is.”

At Scott Counsel, we have personally witnessed several clients and friends who were persuaded to mortgage their homes to invest in Ponzi operations, highly leveraged real estate deals (now underwater) and risky tax shelters. Many of these “opportunities”, if not most, went south and sour. The investors were saddled with the sting and burden of expensive mistakes. If you do not understand how the investment works (including the purported tax benefits), keep your money for another opportunity – which will certainly come along.

Over the past decade, the spotlight has been on two major Ponzi schemes – Bernie Madoff who attracted $65 billion from his investors over a 20 year period and Allen Stanford whose investors entrusted him with $8 billion over a decade. However, most “scammers” do not run operations of that magnitude and NEVER call them Ponzi schemes. Most of the time, they seem like “regular” investments that are doing consistently well. Many people unknowingly invest in Ponzi schemes (which are more prevalent than one might think), trusting others to conduct due diligence and to continue monitoring the investment.

R.P. McCabe and 700 others invested in excess of $100,000,000 in a real estate investment. McCabe, who lost $1 million (most of his life savings), reports that his wealth management company steered him toward the investment which paid off in the 10 to 12% range after about four years. The investors later discovered that the financial statements were phony and that distributions were not profit based but represented funds collected from new investors as well as the capital of current investors.

After becoming aware of the loss at age 65, McCabe fell into a “deep psychological depression” which destroyed his 34 year marriage. Taking control of his life after months of therapy, he decided to write a novel with a theme of financial fraud. In the course of researching Betrayed, he interviewed 200 of the 700 victims about how the scam changed their lives. He reported that “Suicide is very common after financial fraud has been committed. The psychological impact for a lot of us was a deep shame and self-recrimination that we should have seen it coming. The thing is, we weren’t investing in something sketchy. The investors here were not overreaching with some get-rich-quick scheme like a promise of a 25 percent return on something in some banana republic.”

 

For more information on investment schemes and various other scams perpetrated against seniors, check out our Resources page for a free download of Senior Shakedown: The Unknown Dangers of Getting Old, and How to Protect Your Loved Ones written by Principal Attorney Justin L. Scott.

 

If you or someone you love believe they have been the victim of a financial scam, call Justin at 856-281-3131.

Counterfeit Prescription Drugs

Obtaining medical prescriptions online has become increasingly easy and prevalent. Savvy shoppers are learning to do their due diligence and research rather than just fill prescriptions at their local pharmacy. Many online retailers offer greater discounts in bulk amounts with expedited ease. However, there is a sordid side to getting online prescriptions filled. There is a high incidence of counterfeit prescription drugs being made and used to fill every day orders. This is a very common scam that the Food and Drug Administration (FDA) is tracking.

Besides the danger of ingesting something harmful or NOT ingesting the medicine you really need, you are now transmitting your financial information to online con artists. We highly recommend you always verify that you are using approved vendors for medical and financial purchases.

For information on this and many other types of scams targeting the elderly, be sure to check out the Resources page for a free download of our book, Senior Shakedown: The Unknown Dangers of Getting Old, and How to Protect Your Loved Ones.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Medicare and Health Insurance Scams

Who is eligible for Medicare? Generally Medicare is available to people 65 or over, younger people with disabilities and people with end stage renal disease (www.hhs.gov). Medicare has two parts: Part A (hospital insurance) and Part B (Medicare insurance). There are eligibility requirements; which you can find online at www.hhs.gov (U.S. Department of Health & Human Services).

Why are we highlighting Medicare? There are many ways for crooks and financial scammers to find out your age, where you worked, if you paid taxes, where you live, and surmise if you are eligible for Medicare. Some scammers may pretend to be representatives of Medicare in an effort to coax personal information from their targets. Taking it to the next level, there are even reports of fake mobilized clinics where unlicensed services were performed and then Medicare was billed.

For more information on this and other types of scams that con artists used to target the elderly, be sure to check out our book, Senior Shakedown: The Unknown Dangers of Getting Old, and How to Protect Your Loved Ones from our Free Resources page.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.

Internet Fraud

There’s no denying the fact that the Internet is a huge part of daily life for millions of people in today’s society. For younger adults and children, learning to navigate the complexities of the world wide web is easier and is part of daily routines.  This familiarity with using the Internet consistently and regularly leads to the belief that younger people are more likely to recognize internet scams or fraud and avoid them. The same may not be said for seniors and the elderly. Since some older adults tend to have limited access to the Internet, they unknowingly become easier targets for scammers when they do start going online more frequently.

Potential situations that could arise include: falling victim to some pesky pop-up ads claiming their computer is infected with a virus and that a “free scan” (from a fraudulent anti-virus program) is needed to get rid of it. There is also potential that the scan may con the Internet user out of a great deal of his or her money, or even infect the computer with an actual virus that exposes all of the computer’s information to scammers and con artists.

Another internet scam that seniors often fall prey to comes in the form of email or phishing scams. In these types of scams, he or she may get an email from a seemingly legitimate company asking them to either update or confirm any personal information. Another such email scam may even appear to be coming from the IRS regarding a tax refund. We find it is vitally important that seniors and the elderly learn about how to protect themselves online, There clearly are advantages in learning how to use the Internet; we strongly recommend finding safe and proper ways to do so.

If you or someone you love needs assistance with Elder Care law issues, call 856-281-3131. Let us help ease your stress and give you a plan.