Caregiver Shortage - How To Find Quality Care

How do Families find the best quality of care in an environment where there are limited caregivers.

There is no doubt that everyone knows baby boomers are getting older and the elderly are living longer. But many do not realize that the United States is facing a serious shortage of caregivers.

The Wall Street Journal recently came out with the Caregiver Shortage article that America is running out of family caregivers, just when it needs them most. Every day, 10,000 people turn 65. In 2020, there will be 56 million people 65 and older, up from 40 million in 2010.

The private sector isn’t an option for many older adults. Demand for private home health aides is expected to exceed supply by more than three million in the next decade. 

Vetting caregivers on your own can be difficult. Going by word of mouth can work many times, but even then finding a great caregiver that is available can be difficult. That does not take into account the liability of hiring an employee on your own. If something happens to them on your property, the liability is significant.

Choosing the right Home Care Agency has never been so critical. 

Ensuring an Agency, vets, trains, oversees and ensures the proper care continues is important. Follow Elder Care Homecare's guide to choosing a caregiver/agency.

 

Long Distance Caregiving

What is long distance caregiving?

Long-distance caregiving takes many forms—from helping manage the money to arranging in home care; manage medication or coordination care. Many long-distance caregivers act as information coordinators, helping aging parents understand the confusing maze of home health aides, insurance benefits, and durable medical equipment can be difficult.

Caregiving is often a long-term task. What may start out as an occasional social phone call to share family news can eventually turn into regular phone calls about managing health insurance claims, getting medical information, and arranging respite services. What begins as a monthly trip to check on Mom may turn into a larger project to move her to a nursing facility close to your home.

What You Should Do (or Think About Doing)

1) Seek out help from people in the community: the next door neighbor, an old friend, the doctor. Call them. Tell them what is going on. Make sure they know how to reach you.

2) Take steps to identify options to help the primary caregiver. He or she may not need the help now, but having plans and arrangements in place can make things easier if there is a crisis.

3) Try to find a directory of senior resources and services by checking with a library or senior center for lists of resources.

4) Become Healthcare  proxy or power of attorney.

5) Get organized with documentations (updated medication lists, doctors names and phone numbers, and other financial information if necessary)

How to Know if Help is Needed

Sometimes it is hard to know when is the right time. Sometimes our loved ones are stubborn and fight us even though we know they need a little extra help. When you live far away, you have to think carefully about possible signs when help is needed. You might want to use holiday trips home to take stock.

Some questions to answer during your visit include:

  • How many stairs are there?
  • Are the stairs manageable or is a ramp needed?
  • Are there any tripping hazards throughout the house? Carpets, floorboards or other impediments?
  • How is their health? Are they attending all their doctors appointments?
  • Are they taking several medications? If so, are they able to manage their medications? Medication management can be extremely difficult.
  • If a walker or wheelchair is needed, can the house be modified?
  • Is there food in the fridge? Are there staples in the cupboards? Do they have a way of getting food delivered?
  • Are bills being paid? Is mail piling up?
  • Is the house clean?
  • If your parents are still driving, should they be? Now might be a time to assess their driving.
  • What about mood: Does either parent seem depressed or anxious?

Long-distance caregivers can help arrange for professional caregivers, hiring home health and nursing aides, or locating assisted living and nursing home care.

Tips

Become knowledgeable. It is recommended recommend that you learn as much as you can about your parent's illness and treatment. Information can help you understand what is going on, anticipate the course of an illness, prevent crises, and assist in disease management. Learn as much as you can about the resources available. Make sure at least one family member has written permission to receive medical and financial information.

Planning your visits is important. When visiting your parent, you may feel that there is just too much to do in the time that you have. You can get more done and feel less stressed by talking to your parent ahead of time and finding out what he or she would like to do.

Remember to actually spend time with your loved one. Life can get in the way, but it is important to spend quality time with your parent. Do not spend the entire time dealing with medical issues and other planning crisis. Spend some time just catching up.

Stay in contact. Don't lose sight how beneficial it is to just check in once a week or more with a loved one. Include them in your life and activities. Update them on their grandchildren etc...

Hiring a Geriatric Care manager navigate this maze can sometimes relieve this burden. These are professionals who can sometimes act as the "daughter with knowledge".

3 Easy Summer Activities for Seniors

It is important to stay active, but depending on where you live, it can be challenging in winter months. When summer arrives make the most of outdoor activities. Here are three easy ways to stay active and have fun!

1) Go for a walk or run outside! Whether it is just a walk around the block or walking to the park or beach, a little bit of fresh air and vitamin D is great. Make sure to wear sunscreen, and ensure you’re able to easily access cool shade by wearing a hat, bringing an umbrella, or sitting beside a tree. The benefits of walking outside are significant (not just from the physical workout). Seniors who lack vitamin D are at greater risk of fractures.

2) If you have access to an outdoor (or even indoor) body of water, summer is a great time to hop in! Because of the buoyancy, swimming is much easier on the joints than many other forms of exercise. This form of excursion is not only great for your muscles but swimming can be a great way to relax the mind as well.

3) Unique summer activity is Berry picking. If you live in the city you might needs to drive for a while, but picking berries can be a fun outdoor activity (with plenty of water and sunscreen). These activities give people more to talk about with friends and family. Also can lead to more activities such as baking a pie later, or hosting friends. Many times seniors can get into a "rut" since their daily activities become boring. Pushing your body physically, mentally and socially is important to a healthy lifestyle.

 

Hybrid LTC Insurance - WSJ Says New Estate Planning Tool

Estate Planning is Critical. Including a Hybrid Long Term Care Insurance Policies may be a great option.

Check out the Wall Street Journal article on including Long Term Care Insurance "Hybrid" policies in your estate plan.

Many people do not realize the significant cost to caring for a loved one or themselves. Home Care is extremely costly and needs the appropriate planning.

If you have or are looking to purchase a Life Insurance Policy, this may be a great option to look into to include a LTC rider or Hybrid policy.

https://www.wsj.com/articles/long-term-care-insurance-isnt-dead-its-now-an-estate-planning-tool-1528387201

Bronxville Library - Vitamin Therapy Seminar

Join Elder Care Home Care on July 15th at the Bronxville Library while we discuss daily Vitamin and Nutrition.

Vitamins and mineral needs change over time. More importantly, being aware of changes can reduce the impact and allow seniors to maintain optimal health. Please join while we discuss the various ways to improve our health and quality of life through simple everyday changes.

Elder Care - 10 Best Summer Activities for Seniors!

Here are our Elder Care Homecare recommendation for seniors this summer:

1) Outdoor Eating: Make every effort to eat every meal you can outside or attend barbecues. This activities has many secondary benefits for your health

2) Summer Gardening: Whether your elderly loved one already has or wants to cultivate a green thumb, gardening is a great summertime activity

3) Volunteer: Volunteering is a great way to stay active and involved in the community. Sometimes seniors feel that everyone is busy helping them. Volunteering is a great way for them to feel like they are giving back and helping others.

4) Swim: If possible go swimming! Swimming can provide a unique way for aerobics and muscle development in a safe environment.

5) Sports/Events: Attend local sporting event, festivals or activities. This is an easy way for families to spend quality time together.

6) Read a Book: Although this is great to do any time of the year, but sitting outside reading a book is always more fun! 

7) Go for a Walk: Staying active is important. Whether you go for a walk around the block or drive to your local nature center and walk the trails, both are great.

8) Senior Centers: Attend some of the local senior center activities. They have wonderful activities planned throughout the summer, so get involved.

9) Visit Family: Take every opportunity to spend time with family. Sunday dinners, graduations, weekend trips. Whatever it is, spend as much quality time as possible.

10) Don't stay inside or say "tomorrow". Get out and have fun today!

SeniorAdvisor Award's Elder Care- Best Home Care in Scarsdale

Senior Advisor Award.PNG

Elder Care Homecare is proud to receive SeniorAdvisor's 2018 Award for best Home Care Agency in Scarsdale.

Our team looks forward to providing the high quality service that every family deserves. 

Eating Smart - 3 Ways To Improve Nutrition

Focusing on 3 additionas to your diet can make a significant difference in the long run. Add the three below changes to your diet to improve your fight against dementia and other memory declines.

1) Vitamin D: Remember to eat more fish! According to the Alzheimer’s Research Center vitamin D deficiency significantly increases the risk of dementia and Alzheimer’s disease.  And it’s not surprising to find a “D” deficiency in older as well as younger adults. The best ways to improve vitamin D intake is to eat fatty fish, such as salmon, tuna and sardines. 

2) Studies have shown that most vitamin E-rich foods, such as walnuts, almonds and olive oil, had a reduced Alzheimer’s risk. Vitamin E may trap free radicals that can damage brain cells. Healthy snacking on nuts rather than chips can make a significant difference.

3) Lastly a lesser known Vitamin: Anthocyanins. "Recent research from Tufts University found that the antioxidant anthocyanin, found in blueberries, can protect brain cells and boost communication between brain neurons." Supposedly consuming two or more half-cup servings of blueberries or strawberries per week had a slower rate of memory decline than those who didn’t eat the berries.

Elder Abuse: Can Be Self-Inflicted

Elderly patients many times neglect themselves. The NYTimes wrote a fantastic article related to this subject:

"The man was living alone with his two dogs, in a remote area outside San Antonio, when someone called the Texas state hotline to report that a supposed friend was financially exploiting him. So the state adult protective services agency sent a caseworker to the man’s home.

She found an 86-year-old Vietnam veteran in a dirty, cluttered house full of empty liquor bottles. His legs swollen by chronic cellulitis, he could barely walk, so he used a scooter.

He missed doctor’s appointments. He had the medications he needed for cellulitis and diabetes, but didn’t take them. Though he had a functioning toilet, he preferred to urinate into plastic gallon jugs. He didn’t clean up after his dogs. He wasn’t eating well.

This behavior pointed to an underrecognized problem called self-neglect. It accounts for more calls to adult protective services agencies nationwide than any other form of elder abuse."

The article continues to show how a patient can deteriorate in a short time. After Adult Protective Services forced him to accept help, things took a turn.

"Grudgingly, he allowed the agency to set up a thorough housecleaning, to start sending a home care aide and to arrange for Meals on Wheels.

But on a follow-up visit a month later, the caseworker found her client markedly deteriorated. His swollen legs now oozed. He’d become personally filthy and was ranting incoherently. She returned with an ambulance and a doctor who determined that the client lacked the capacity to make medical decisions.

Off he went to a San Antonio hospital, under an emergency court order. The caseworker locked up the house and kenneled the dogs.

“Family members get fed up and don’t want to get involved,” said Courtney Reynolds, a research analyst at the Benjamin Rose Institute on Aging in Cleveland. “They attribute it to a character issue, like stubbornness, instead of a decline in the person’s ability to manage.”

Families are often reluctant to get involved and find their parents or grandparents incredibly stubborn. It is critical for family members to stay involved and push necessary services to ensure the health and safety of family members.

Feel free to read the entire article at the below link:

Elder Abuse: Self-Infliction

Four Tax Breaks To Help Care For Elderly Parent

Millions of people across the U.S. are caring for their elderly parents. Providing that care can be vital as well as expensive: The out-of-pocket expenses can run over $100k on average in families in which an elderly person has long-term care needs.

However, there are a few tax breaks might help. These aren’t the only ones that might be available, but some common ones we have seen.

1) Dependent Exemption

You might be able to claim all or part of an exemption of up to $4,050 if your adjusted gross income was less than $436,300 (for joint filers) or $384,000 (for single filers) in the 2017 tax year.

2) The Child and Dependent Care Credit

If you paid for someone to take care of your parent so you could work or actively look for work, you might qualify for a credit that generally runs 20% to 35% of up to $3,000 of adult day care and similar costs. Tax credits directly reduce the amount of tax you owe, giving you a dollar-for-dollar reduction of your tax liability. A tax credit valued at $1,000, for instance, lowers your tax bill by $1,000.

3) Employer’s Dependent Care Benefits

Another tool is: The IRS will exclude up to $5,000 of your pay that you have your employer divert to a dependent care FSA account, which means you avoid paying taxes on that money. 

4) The medical expenses deduction

If you paid for Mom’s hospital stay or footed the bill for expensive medical or dental care and weren’t reimbursed by insurance or other programs, you might be bale to deduct the cost.

In general, you can deduct qualified medical expenses that are more than 7.5% of your adjusted gross income. 

Caring for loved ones can be difficult and put a strain on families expenses. Utilize all the tools at your disposal.

Long Term Care Insurance - Using Your Policy

"Long Term Care" refers to individuals that need help with an illnesses/condition that require daily assistance over an extended period of time. The type of help needed can range from assistance with simple activities (such as bathing, dressing and eating) to skilled care that's provided by nurses, therapists or other professionals.

Employer-based health coverage and Medicare will not pay for daily, extended care services. To help cover potential long-term care expenses, some people choose to buy long-term care insurance.

Qualifying for Benefits

"Benefit triggers" are the conditions that must occur before you start receiving your benefits. Most companies look to your inability to perform certain "activities of daily living" (ADLs) to figure out when you can start to receive benefits. Elder Care Homecare can help ensure patients and families understand these needs.

Generally, benefits begin when you need help with two or three ADLs.  You should be sure your policy includes bathing in the list of benefit triggers because this is often the first task that becomes impossible to do alone.

Pay close attention to what the policy uses as a trigger for paying benefits if you develop a cognitive impairment, such as Alzheimer's disease. This is because a person with Alzheimer's may be physically able to perform activities but is no longer capable of doing them without help. There are Mental-function tests are commonly substituted. 

Additionally there are generally qualifying periods. Many policies require families to utilize services prior to policies activation for 30, 60, 90 day periods. This is critical for families to know in advance.

For more information or help utilizing your policy, feel free to reach out to the Elder Care Homecare team.

Four Mistakes To Avoid When Hiring A Caregiver

Depending on the type of care your parent needs, there are factors you need to consider. So if you’re considering hiring an in-home caregiver here are four common mistakes you should avoid.

Putting it off. There is a lot of evidence that shows using a professional caregiver improves the psychological well-being of nonprofessional caregivers (home health care, adult day care, adult programs). Studies in publications like the Journal of Aging and Health have found that people often seek professional caregivers to alleviate stress and depression that results from taking care of a loved one around the clock.

Not vetting the caregiver or agency. This process can be intimidating and overwhelming, especially if a friend or family member recommended a caregiver. But this is a big decision. Do not make caregivers a "commodity". The caregiver will be spending an extraordinary amount of time with your loved one. Ensure it is the right fit and the agency provides the support you need.

Not keeping everyone in the loop. If you have been taking care of a loved one, and you have siblings who are too busy, lazy or unfocused to help, it'll probably fall to you to hire a professional caregiver. But once you find a contender for your parent's caregiving needs, ask your siblings to sit in on the interview process, which may help you avoid contentious issues later.

Not staying involved. It's important to periodically ask your mom or dad how things are going with the caregiver in case needs aren't being met.  Consistent oversight is critical to ensure you and your family are happy with the care that is being provided.

This Fall - Innovations in Home Health

Companies are constantly trying to connect patients with care providers in a cost effective way. Pairing Nurses, Social works and Doctors with their patients remotely is the next trend.

While ride-sharing apps like Uber and Lyft have certainly become common across the in-home care industry, the next trend is becoming "the on-demand" in-home care services. Giving power to care providers to control their schedules.

There are two exciting apps we found that can improve Home Health Care. First, applications such as Axxess or Optimal Care Coordinators pair nurses and social workers in the field with local needs. Nurses are able to identify clients that meet their schedule and ensure they are qualified to handle the patients needs. Secondly, telehealth services are becoming a great focus in the industry. Using digital health tools and telehealth platforms to better care for patients after they leave the hospital is critical. Technologies enable organizations to proactively monitor home care patients and provide in-the moment interventions that can make the difference between patients staying at home or being transferred to the hospital.

These technologies can not only help patients receive improved care, but also reduce the cost of health care to the system. Hopefully the industry will continue moving in this direction to improve care.

Latest Technologies to Reduce Hospital Re-Admissions!

Doctors and medical professional are constantly trying to stop hospital re-admissions and cut costs. But they continue to leave out that patients also prefer to have better care and faster recoveries. Reducing pain and going back to the Hospital should be avoided at all costs. Focusing on helping the patients and encouraging them to use a variety of platforms/solutions can hopefully help improve their recovery or care.

Makers of mobile apps continue to build platforms to gather data and improve care broadly. They claim that they can boost patient engagement and help hold down healthcare costs. Below see a few of our recommended Apps:

  • Propeller Health’s sensor and mobile app allows patients with COPD and asthma to track inhaler utilization by transmitting data to physicians about when and where the medication is used in an effort to help prevent an attack or exacerbation.
  • SeamlessMD’s mobile app system asks the patient to enter information about temperature or pain level to gauge warning signs of surgical complications. It also allows patients to submit photos of surgical wounds to share with a doctor.
  • The Vocera Care Experience is a system that allows nurses and caregivers to record audio and video discharge instructions for patients, who can access discharge information anytime using a phone, mobile device or computer.
  • Vital Connect’s HealthPatch MD is a biosensor that captures biometric data and can detect falls and allows providers to track a patient’s heart rate, respiratory rate, skin temperature and other data points. Patients can wear it for post-operative recovery care.

Why Check Ups Matter

Generally, people try to avoid going to the doctor as often as possible. No one can say they have fun or enjoy check ups. The whole process can discourage individuals. First you go to his/her office and you have to sit there - for who knows how long - reading years-old magazines or scrolling through old emails on your phone. Finally once the Doctor is ready to see you, you are led to another room and made to wait. Again. This does not even include the actual check-up! It is no wonder people don’t like going!

But you know what would be worse? Finding out that you have a condition that could have been prevented had you been seeing your doctor regularly.

So even though it can be an inconvenience, it is important to have regular checkups with your doctor. Here’s why:

1) Never under estimate the power of prevention. Preventing a health issue is always better than having to find a treatment or cure for one.

2) Regular Doctor visits is your first line of defense to prevent health issues. When you see your doctor there are a variety of screenings they can perform 

3) Constant dialogue with your doctor is critical. This allows them to know what your typical numbers are (blood pressure, cholesterol, heart rate and any other testing they might do for you). Having a baseline of information as you go for a checkup year in and year out, your doctor can see your history and will easily be able to determine even the slightest changes.

4) Lastly, there are also the health costs to consider around yearly physicals. This argument is not helpful. Imagine what you will need to be spending if you have something major – medically speaking – go wrong.  The costs to deal with a health issue, the days - weeks off from work, or the terrible feelings, will far outweigh the small price for regular checkups with your doctor. 

No matter how you choose to look at regular or yearly checkups, they can make a positive difference in your future health and well-being.

https://www.cdc.gov/family/checkup/

Occupational Therapy: Its Importance and Quick Tips

Occupational Therapy Tips for Seniors

If a senior you love is preparing to begin occupational therapy, there are steps you can take to ensure the best possible outcome. Those include:

  • Set goals: Work with the therapist to set realistic goals. While the ultimate goal may be to drive a car again, it helps to break that goal down into smaller objectives. It might be to regain the range of motion necessary to look over their shoulder and merge in traffic. Another objective might be to master pulling the seat belt over their shoulder and locking it.
  • Encourage patience: Along these same lines is the need to be patient. One of the challenges seniors face as they begin their therapy is that it often takes time to make progress. Encourage your senior loved one to be patient and not be hard on themselves.
  • Dress comfortably: Therapy can be hard work! Dressing comfortably, including wearing comfortable shoes, can help make occupational therapy sessions a little easier.
  • Celebrate small victories: You can also help your loved one stay motivated by celebrating small victories with them. This is especially true if they have a long road ahead of them with regard to their recovery. It might be with lunch out, a bouquet of flowers or a milkshake from their favorite ice cream shop.

Seniors: Consider Rideshare - Uber, Lyft and Others

Driving can become a serious challenge for seniors as they age in place due to injury, disability or fear of getting behind the wheel.  Rideshare services, such as Uber, Lyft of Gett can support seniors in their transportation needs. This allows them to travel safely and securely without an problems. Senior are always hesitant of new technology or new forms of transportation, but as many young individuals know, rideshare services are great. 

There are unique challenges and needs of the elder population and utilizing every tool to enhance their independence and reduce isolation is important. At Elder Care we recommend Rideshare services as a cost effective solution for many families in need for transportation services.