The Walk to End Alzheimer’s (2014)

August 26th, 2014

The Walk to End Alzheimer’s (2014) Guest: Candace Douglas, Director of Constituent Events, Alzheimer’s Association, NYC Chapter

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Four Ways Primary Family Caregivers Can Manage Stress

August 25th, 2014

Home care

 

 

 

Our latest guest blogger is Lou Giampa, is the President of Right at Home Westchester. Lou is a New York State Certified Nurse Aide (CNA) who volunteers in hospitals and nursing homes throughout Westchester County.  He also volunteers with the Alzheimer’s Association, Meals on Wheels, and the Aging in Place community.

 

First, Dad needed help monitoring his daily medications, and then he needed to be taken to physical therapy twice a week. During the next few months, Dad’s health continued to wane and he wrestled with losing his independence.

If you are a primary family caregiver, you understand the tough sacrifices and rewards of helping your elderly loved one maintain their independence. You are alongside them for the activities of daily living such as bathing, dressing and eating. You step in when there are medical and financial decisions to be made. You break the doctor’s news, you give the chin-up talks, you listen to the reminiscences of days gone by, and you love and are there without question.

Yet, like millions of other chief family caregivers, your life is expanding in scope and responsibility. If you juggle care-giving with your own family’s needs and a career, you sense the intense squeeze of time and commitments all the more. With your loved one’s care continually on the front burner, your care needs stay on the back-burner. Without realizing it, your efforts to comfort and support your senior may be eroding your own health. Primary family caregivers are more susceptible to high blood pressure, stroke, diabetes and anxiety. Stress from caring for an aging loved one also can increase the likelihood of headaches, disruptive sleep and depression.

“Primary family caregivers deserve a supportive round of applause because they work so tirelessly to serve their senior loved one, often without a break or even a “thank you,” said Lou Giampa, President of Right at Home Westchester.  “Our professional at-home caregivers understand the need for family caregivers to reserve time for their own mental, physical and emotional health. I encourage family caregivers, especially the main caregiver, to take care of themselves regularly and not wait until they hit the frazzled and fatigued state.”

Your aging loved one needs you functioning at your best, so relieving stress is vital to everyone’s health to manage day-to-day and long-term priorities. Giampa recommends the following stress busters for principal family caregivers:

  • Refresh your own health. Exercise at the gym or go for a brisk walk a few times a week. Be sure you maintain good nutrition and sleep habits. Check in with your own doctor on annual exams and ways to support your own optimal health.
  • Recruit help. Enlist the support of family members, friends and neighbors who can lend caregiving help. Also, rely on regular respite breaks through the assistance of a professional in-home caregiver. From getting help for a few hours a day to regular overnight care, securing adult home healthcare is a sign of wisdom and strength, not a sign of weakness or inability to care well.
  • Stay connected. Keep up your own family connections and friendships. Having a confidant who listens to you is crucial as you navigate the unknowns and challenges of caring for another person. Local or online caregiver support groups are another beneficial way to learn with others about realistic expectations and goals to prevent caregiver burnout.
  • Continue with your own life. To maintain balance, it’s important to stay active with your own interests, hobbies and social groups. Don’t skip the fun events or forgo your normal faith and community activities.

When primary family caregivers learn to relieve stress regularly – before health issues arise – they help safeguard their loved one’s care and preserve the relationship with their loved one – one shared meal, one doctor’s report and one fond memory at a time.

About Right at Home

Founded in 1995, Right at Home of provides in-home care and assistance to seniors and the disabled.  We help care for seniors who require some assistance in order to maintain their independence, improving their quality of life, and enabling them to remain in their homes.  Our caregivers help with all the activities of daily living, as well as cooking, light housekeeping, safety supervision, medication reminders, and transportation to medical appointments, grocery shopping, social activities, etc. Our caregivers are thoroughly screened, trained, and bonded/insured prior to entering a client’s home.

 

If you or someone you know could benefit from in-home care, please visit www.westchesterseniorcare.com. For more information, please contact our office at 914.468.1944

 


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Some Seniors May Prefer Naturally-Occurring Retirement Communities

August 12th, 2014

Although many retirement communities are constructed after thorough planning, it is not the only way for such a community to develop.

The term “retirement community” usually refers to a neighborhood or apartment complex that was designed for seniors, and may be restricted to residents above a certain age, such as 55. Large developments of this kind have proliferated across the Sun Belt and elsewhere, offering a variety of activities and services to seniors. At the same time, other neighborhoods underwent an unintended demographic shift over time, until the majority of residents were seniors. These naturally-occurring retirement communities (NORCs) can qualify retroactively for funding for seniors’ support services, while providing the generational diversity that some older people prefer.

Many seniors want to live in a neighborhood where they can meet people their own age and take advantage of services and activities that are geared toward their needs, but they also want to live in a diverse area where children and young people may not be next door, but are not miles away either. Sometimes these communities occur naturally, as people age in place or as more older people move in. In addition, some developers are now mimicking NORCs by building small retirement enclaves in generationally diverse areas, an alternative to sprawling retirement communities where thousands of seniors may live separately from young people.

NORC is a term that has been in use since 1986 and is recognized by all levels of government. In New York, once a community meets certain criteria regarding the size of the population of older people, funding may be available from local, state or federal government agencies to provide services such as health care, social services and recreational activities. There are currently 27 recognized NORCs in New York City alone, and with the large baby boom generation aging, the number of these retirement communities can only be expected to grow.

Learn more about retirement communities and other options for seniors at www.elderlawnewyork.com. 

 

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Should You Consider a Trust for Your Child’s Inheritance?

August 4th, 2014

This conversation comes up a lot with our estate planning clients: “So, you’re leaving your entire estate equally to your three kids,” we say to our client. “Do you want to leave it outright or would you consider putting it in a trust for them?”

The two most common responses:

  •  “No, my kids are all OK. They can manage money and would be insulted if their inheritance was left in trust.”
  •  “No. If they can’t manage their inheritance then I can’t help them. I don’t want to try to control things after I’m gone.”

Then, we explain that creating a trust is actually a good thing for the kids but it’s usually hard to convince clients. So let’s try it here, and then we can just hand them this article.

Why consider a trust for your child’s inheritance? It may be a real benefit to them, protecting their inheritance from their creditors, spouses, even estate taxes. Let’s look at each of those concepts briefly:

One common concern we hear: “we love and trust our daughter, but though we like her husband we wouldn’t want him to inherit our assets if something happens to our daughter.”   By creating a trust for your child’s inheritance, you make it easier to keep the property separate from spouses and more likely to pass to your grandchildren on your child’s death. Sadly, divorce is very common: you can help keep the inheritance from being considered as part of the property to be divided if your daughter does divorce.

Let’s consider creditors. “Our son is a doctor,” you say, “and he has plenty of money.” Ah, but professionals are vulnerable to future malpractice lawsuits, and anyone can have even a substantial estate drained by an auto accident or medical crisis. Creating a trust for your son can help protect the inheritance from lawsuits, creditors, and bankruptcy.

How about taxes? If your daughter is a successful professional, she might well have a taxable estate on her death. That could be true even though she is not particularly close to that figure today. If estate taxes do kick in, they start at a very high 40% on the federal level. New York currently has an estate tax on estates over $1 million.  If you leave your daughter’s inheritance in trust, you can fairly easily arrange to keep it out of her “estate” for tax purposes.

So there are good reasons to leave an inheritance in trust, even though all your children are responsible and your estate is modest. But aren’t there some serious downsides? Doesn’t it mean a lot of additional costs and imposition of a bunch of difficult rules? Not really.

Depending on your family circumstances, you might even name your son trustee of his own trust. Or make your son trustee of the trust for your daughter, and make her trustee of his trust. Or make your daughter (you know, the one with her CPA who works for the bank) trustee for all the kids’ trusts. In other words, creating a trust does not mean you have to incur professional trustee fees though it might actually make sense to name a non-family trustee. We can talk about those options.

The trusts for your children will have to file tax returns each year. That will in fact mean a small additional cost. But the total amount of income tax paid need not increase. It should be fairly easy to assure that each trust’s income is taxed to its beneficiary, rather than paying taxes at the (often much higher) trust rates. We can talk about those issues, as well.

What about your son’s access to the money? Do you think he might want to use his inheritance to pay off his mortgage, or to allow him to put more away for retirement, or to send your grand kids to college? You can give him the power to demand money from the trust, or give the trustee direction to follow those kinds of requests. Let’s talk about how much control you want to give each of your children over the trust while they are alive. And on their death, you can even give your children the power to name which of their children (or spouses, or charities, or whomever you want to permit) will receive the remaining trust’s assets.

Cost? Setting up a trust for each of your children will likely increase the cost of your estate planning but by a pretty small number, in most cases. These principles apply even (perhaps especially) if you are leaving your estate to grandchildren, nieces and nephews, or anyone other than your children.

As you can see, there are many benefits of using a trust in your estate planning.  Keep in mind, however, that one size does not fit all and it is important to have your documents tailored to meet your specific needs.

Learn more about elder law and estate planning by visiting www.elderlawnewyork.com

Guest Post: Staying Aware and Safe in the Summer Heat

July 23rd, 2014

By Susan Yubas, founder of FYI Senior Living Solutions, Inc.

My daughter and I walked into my mother’s apartment the other day and were hit by a wall of warm, humid air.  While my mother was wearing long sleeves and pants, my daughter began to roll up her sleeves due to the heat and I immediately went to see why the air conditioning was not working.

It was working fine – she had turned it off because she was comfortable and did not feel the heat.

Dangerous.

As we age, our bodies lose the ability to regulate temperature which makes us sensitive to seasonal weather changes.

Serious conditions are related to heat exposure – including heat exhaustion and heat stroke.  While the two share similar symptoms of headache, dizziness,  and fatigue, heat stroke is life threatening and may also include disorientation, agitation, seizures, fainting, rapid heartbeat and hallucinations among others.

Being dehydrated also increases the risk of exposure to heat for older adults and some medications for chronic medical conditions like diabetes, high blood pressure and heart disease may increase susceptibility to dehydration and also result in increased sensitivity to sunlight.

What can you do:

  • Make sure older adults drink plenty of fluids throughout the day.  If their doctor generally limits the amount of fluid they drink or they are on water pills, they will need to ask their doctor how much they should drink while the weather is hot.
  • Avoid direct exposure to the sun during the peak hours of the day
  • Limit exercise during the hottest part of the day
  • Cool down and rest in an air conditioned space.

Always seek medical attention if you are concerned about an older adult during the hot summer months ahead.

Susan Yubas is a Certified Senior Advisor and the founder of FYI Senior Living Solutions, Inc.  She will help you articulate your goals, identify issues you may not have considered and direct you to appropriate professionals to help you implement what is needed.

 

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Advance Directives Need to Be Accessible

July 8th, 2014

When drafting advance directives, a common problem for many people is making these documents easily accessible for their loved ones.

What is an advance directive? A legal document in which a person specifies what arrangements should be taken for their health if they are no longer able to make decisions for themselves because of illness or incapacity. There are different ways of creating advance directives, including a living will, a durable power of attorney and also a health care proxy.

People may feel that their advance directive should be kept with their attorney or in a safe deposit box. However, decisions about medical treatment often need to be made quickly, so it is important that an advance directive be not only safe, but easy to get to.

If an individual’s advance directive appoints another person as health care proxy, then that person should have a copy of the document, or know where it is kept. If a patient is incapacitated, then it is important that the health care proxy be able to present the document to medical personnel.

It may also be wise to keep a copy of the document in electronic form, stored in such a way that it is accessible from a smartphone or other device. Such electronic copies have the same legal authority as the original paper document, and they can be accessed more easily. Ask your attorney what they recommend for digital or cloud storage for these documents to ensure the security of your private information. Learn more about our services within elder law and advance directives by clicking here.

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Traveling with an Older Adult

June 25th, 2014

By Susan Yubas, founder of FYI Senior Living Solutions, Inc.


As we prepare for a trip with older members of our family, we want the plans we make to be as uncomplicated and stress free as possible.  “Ha, ha,” you laugh.  Travel is complicated and stressful on its own these days, let alone when you are traveling with an older adult who may be frail.

Here are some tips to ease the way:

  • Review your travel plans with their personal physician so you know if there are any special needs you should be aware of and plan for in advance of your arrival.
  • Make sure you know the health insurance company’s requirements for out of network or emergency care – sometimes a family definition of emergency is different from that of the insurer.  Bring a copy of insurance cards with you on the trip.
  • Bring a current medication list and medications in their original pharmacy bottles.  Carry the medications with you – never pack them in checked luggage or in a place that you cannot get to easily.
  • If an older adult has difficulty walking long distances or easily gets short of breath, arrange for a wheelchair.  It is important that you do this well in advance of arrival at the airport as having the wheelchair available at curbside will allow you to navigate security and get to the gate more easily and safely.
  • Familiarize yourself with available medical resources at your destination in advance.
  • If you will be traveling quite a distance, you may want to consider travel insurance that includes medical transport and/or trained personnel to accompany you to a care destination should the need for urgent care arise.
  • Be flexible with your schedule and enjoy your trip!

Susan Yubas is a Certified Senior Advisor and the founder of FYI Senior Living Solutions, Inc.  She will help you articulate your goals,identify issues you may not have considered and direct you to appropriate professionals to help you implement what is needed.

 

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Planning Considerations when your Elderly Parent Moves in

June 17th, 2014

Have you considered having an elderly parent move in with you? Many people face this decision because of financial circumstances or because their parents need assistance with daily activities. Living with an aging parent can provide an opportunity to reconnect in a positive way but it also demands life style changes. Proper planning can make the difference in ensuring that this transition is smooth.

  • Communication is key. When adult children of elderly parents think about how they intent to care for them, it is important to broach the subject with their parents early on to gauge their feelings. There are situations in which older people in which older people do not want to face the fact that they need help and may be resistant to leaving their home or accepting the care they need. However, even in these cases, any accommodations that can be made to the parents’ own preferences will make the transition easier for everyone.
  • Advance planning is crucial, especially regarding financial matters. Remodeling may be necessary to make one’s home senior-friendly. For instance, if changes need to be made to permit wheelchair access or to add or remodel a bedroom or bathroom, then these costs need to be planned for. If part of the plan is to rely on proceeds from the sale of the parents’ home, then this too requires arrangements to be made well advance.
  • What types of care are covered? It is important to consider what care one’s parents may need as they grow older, and how to pay for it. When making the decision to have an elderly parent move in to one’s own home rather than an assisted living facility or nursing facility, one needs to consider whether an in-home caregiver will need to be hired. If so, that cost needs to be included as one considers the financial planning aspect of the move. Is there a long-term care insurance policy? What Medicare or Medicaid coverage is in place? Take the time to learn what type of care may or may not be covered. Do not assume that providing care oneself is the least expensive option. Time taken away from work and incidental care-giving costs can add up and needs to be planned for.
  • Communicate with Siblings. It is important to communicate with siblings regarding the cost of care. If an elderly parent is moving in with one sibling, then there should be clear communication with the other siblings about how they intent to contribute to their parents’ care.

Caregiving has financial and emotional costs that may not be recognized by others if they are not expressed. In addition to getting help from one’s siblings, if possible, adults caring for elderly parents should take full advantage of any services that are available to seniors and their caregivers in the area.

 

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Horses May Help In Alleviating Alzheimer’s Symptoms

June 13th, 2014

A small pilot study indicates that equine therapy – spending time grooming, feeding and walking with horses – eases symptoms of Alzheimer’s dementia, making patients calmer and happier.

Equine therapy is used today for children and teenagers with emotional and developmental disorders, and the new study indicates that it may also be useful for older adults with Alzheimer’s disease.

Researchers at Ohio State University studied 16 people with Alzheimer’s disease who participated in activities at an adult senior daycare center. Eight of the seniors who volunteered for the study were taken to an equine education center while the other eight pursued other activities at the center. The clients visited the farm once a week for four consecutive weeks, grooming, walking and feeding the horses under the supervision of caregivers.

The researchers found that the patients who interacted with horses showed an immediate positive mood change and were less likely to resist care or become agitated later in the day.

 

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Avoiding Medicare Mistakes

June 3rd, 2014

Americans approaching retirement age are usually aware of the basic facts about Medicare. However, people sometimes make assumptions that can lead to pitfalls. It is important to know what to do and when, because mistakes can cause penalties.

One mistake some people make is assuming that they will not qualify for Medicare because they have not worked long enough. The waiver of premiums for Part A (hospital insurance) is based on the payment of Medicare taxes by applicants or their spouses for at least 10 years. However, for those who do not qualify for a waiver of Part A premiums, they still have the option to enroll in Part A and pay premiums.  Additionally, one does not need work credits to be eligible for Medicare Part B (physicians’ services) and Part D (prescription drugs).

A common mistake that people may make for different reasons is failing to sign up for Medicare at the right time. To avoid late penalties, one must sign up for Medicare during their designated Initial Enrollment Period.  Your Initial Enrollment Period is a seven-month period beginning three months before the month you turn 65 and ending three months after the month you turn 65.  This is true even if your “full retirement age” for Social Security retirement benefits is age 66

Sometimes people hear about the Medicare “Open Enrollment Period” in the fall of each year and believe that this is when they should first sign up for Medicare. Actually, Open Enrollment is when people who are already receiving Medicare may change their Medicare coverage or plan for the following year. First-time Medicare enrollees must sign up during the three month period before and after they turn 65.  One legitimate reason to delay signing up for Part B is if you continue to have health coverage from an employer after age 65; in this case you can delay enrollment in Part B with no penalty.

Finally, it would be a mistake to decide not to sign up for Part D just because you do not currently take any prescription medications. An unforeseen medical condition could necessitate expensive prescriptions, and having a Part D plan can be crucial.

 

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