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Archive for the ‘
Lifespan Planning ’ Category
Who will care for us when we are elderly and frail? This is something most of us in the working world don't want to consider. We are currently busy doing our jobs, being involved in family activities, and possibly worrying about paying for college, retirement or both. But, what about our own long-term care needs?
Long-Term Care (LTC) Insurance now exists privately and through many employers and can help pay all or part of our long-term care needs. Long-term care itself can be quite expensive. The cost depends on the amount and type of care you need and the location in which the care is provided. The average cost of nursing home care is now more than $60,000/year, and in-home care costs about $12 – $20/hour. Long-Term Care Insurance is a program which can pay for many of the costs associated with assisted living, nursing home or in-home care once the physical or cognitive care needs exist. If we look at who currently pays for LTC, we see that Medicare and supplemental health insurance only pay for about 5% of care while private funds are used to pay for about 33% of the Long-Term Care needs. The state Medicaid program pays about 50% of the costs for nursing home care statewide but is only available after all of an individual's private funds have been exhausted.
You should NOT buy Long-Term Care insurance if:
- You can't afford the annual premiums
- You have limited assets
- Your only source of retirement income is through Social Security
- You have trouble paying for food, utilities, medicine or other important needs
You should CONSIDER buying Long-Term Care insurance if:
- You have significant assets and income
- You want to protect some of your assets and income
- You want to pay for your own care
- You want to stay independent of the support of others
- The policy should offer you several Daily or Monthly Benefit Amounts from which to choose for Long-Term Care – policies usually have you select the daily limit ranging from about $50 – $250/day.
- It should include in-home care, other community based care and assisted living, not just nursing home care.
- Evaluate the Benefit Triggers such as needing assistance with two out of six Activities of Daily Living (ADL) rather than needing assist in three or more Activitie of Daily Living.
- It should include care for cognitive impairment.
- Inflation protection, depending on the age at which you buy into the policy, can be important.
- Evaluate the length of the Elimination Period before benefits can start to see if it matches well enough with your supplemental health insurance and/or income/assets. Most policies offer 30, 60 or 90 day elimination periods during which you are responsible for the cost of your care.
- Is the parent company for the policy a solid, long standing and financially solvent insurance company?
Lon Term Care insurance programs do screen for health concerns and individuals with significant pre-existing health issues may not be eligible for this insurance. It is wise to buy insurance while you are still healthy. The annual premiums are also lower when you are younger. Someone in their 40's should start considering the various polices as part of the financial planning process and most people should buy into a policy by age 55. The upper limit that the insurers will accept is usually around 75-80 years old.
- The Federal Government’s Elder Locator program is an excellent resource. Their Web site is http://www.eldercare.gov/Eldercare/Public/Home.asp. Their telephone number is (800) 677-1116.
- The Virginia State Corporation Commission puts out a document called "Facts About LTC Insurance in Virginia" available through their office at (877) 310-6560 or on-line at www.vda.virginia.gov/ltcfacts.pdf
- Our local Jefferson Area Board on Aging has an insurance specialist on staff. Sally Mank with VICAP can be reached by calling at (434) 817-5222x 248.
- www.aetna.com/group/commonwealthva/ provides information on the Aetna policy offered through UVA, or call 877-894-2470.
Always review policies carefully and compare several before deciding on one.
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Introduction – Planning for the Unexpected
As we move through life stages and transitions, it seems nothing is more predictable than change. Although there are many positive things we can do to "get ready" for parenting, marriage, empty nest, growing older, we can never know exactly what the future might hand us. Lifespan planning involves anticipating and planning for one’s future needs. These may be health needs, financial needs, or retirement needs for you and your family.
However, sometimes we must cope with life's unexpected challenges. We need to create our life plans with a "reality check" – knowing that we may need to adjust them or ourselves to face the unexpected.
Have you ever noticed that some of us seem to be able to "go with the flow" much better than others? What are those strengths or assets that these people possess? Can we begin now to develop these characteristics in ourselves in order to face life's startling surprises? Here are some ideas to do just that.
Kendra's life plan never included parenting two toddlers at age 60. Yet, when her grandchildren were removed from her son's home, she had a big decision to make. With much ambivalence, and a lot of heart, she took them in. Needless to say, her plans and expectations of life in her 60's changed dramatically.
The first thing Kendra did was to face the facts….she knew this was not going to be easy and that she would need help. The first words of M. Scott Peck's bestselling book, The Road Less Traveled are "Life is difficult." When we write our life scripts as though everything will be smooth sailing, we can be devastated by trouble and difficulty. Kendra had learned a long time ago to accept both the good and bad of life.
When challenges come, many of us fight against them. Think of the time you learned your teenage daughter was pregnant, or your parent had cancer, or that you did not get the job you had counted on. Initially, we want to run from changes like this. But when we can learn to lean into reality, no matter how painful, we are often in a better position to handle the challenge.
Sam had been working for this job opportunity all his life. He just knew they liked him at the interview and was really excited about moving across the country. Then the call came. He was shocked when they turned him down. Sam went into an angry depression. How could this happen to him? He isolated himself – stopped eating much and slept very little. He found it hard to believe this had happened.
Fortunately, with the help of others Sam began to realize that he could either stay in this dark place forever, or that he could pick up the pieces and move on. Yes, it was a painful disappointment, but he wasn't going to let it take him down for good. He started talking with friends about how hard it was. Then he began to think about his current options. He still had connections. This wasn't the only company in the world. His wife agreed to support them financially while he searched for the next opportunity.
Once we face whatever it is that has interrupted our life plan, we can realize we do not have to go it alone. Some of the brightest, most capable people are those who can ask for what they need. Kendra and Sam learned that their success or failure depended upon themselves and those gathered around them who could help. Highly trained, professional social workers are among those who can provide guidance and support to help individuals cope with difficult situations like Kendra's and Sam's.
Social Workers are professional team members who have special skills to share that can make life transitions more successful. We offer empathy and support, but we don't stop there. We have studied ways you can use to alleviate real illnesses like depression or anxiety that can show up at times of distress. We know of other resources in the area that can benefit you. For Kendra, it was a Grandparent's Group that met at a local church. We can help you adjust your life plan to fit your new situation. But social workers know we are only part of the team you will need. We realize that family, friends, community, church groups, and others will be vital to your success.
Make your life plan, but don't hold on too tight. Prepare that the unexpected will come. When it does, face the facts, get support, and lean into change. The best of life is still waiting for you!
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Introduction
Lifespan planning involves anticipating and planning for one’s future needs. These may be health needs, financial needs, or retirement needs for you and your family. There are many highly trained social workers available who can provide you with valuable services and who can recommend relevant resources.
Many young adults in their 20s are in college or are just starting out in the workplace. Highly trained social workers are available to give them career counseling and help them focus on achievable goals.
Millions of young adults in their 30s and are focusing on making a home and raising a family. Social workers can offering a variety of counseling to young families such as referring them to financial counselors and attorneys who can help them buy a house and save for their retirement. They can help young families stay healthy by counseling them on diet and exercise. They can also assist children who are having trouble in school.
Many adults in their 40s and 50s have concerns for their retirement years as well those of their parents. Someone in his or her 40s and 50s may be thinking of employment options such as early retirement or even changing careers. Social workers are an excellent resource for career and retirement information. This is a time for considering vital aging issues.
Some adults in this age range become caretakers for their parents or other elderly relatives. At this stage their are some legal considerations that can be discussed with a social worker such as the need for parents to have a will, a durable power or attorney, a trust, or joint ownership and tenancy. This is also a time to discuss advance directives. Does the person being care for want to be resuscitated if gravely ill for example. This information should be put in writing and a social worker can help you with this.
Social workers can provide counseling to seniors and their loved ones to help them stay vital and in good health. It is also very common for social workers to help seniors who have mental health issues. In addition, social workers can teach the elderly how to relieve stress, and avoid anxiety and depression. Social workers can also help seniors to things such as prepare for doctor’s appointment, identify care options such as assisted living facilities, help seniors navigate the complex Medicare system and deal with insurance issues, and help them find legal or financial assistance.
In conclusion, social workers are available to help you at any stage of of the lifespan continuum.
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Introduction
Do you ever worry about how you can balance caring for your children with caring for an aging parent? Or perhaps you, yourself, are an older person who wants to be sure to get the most out of your visits to the doctor? Rest assured, you are not alone. With the numbers of older Americans quickly rising, many people are facing these and similar questions every day.
As the "Baby Boomer" generation ages, local, state, and federal agencies are facing the challenge of providing services that older individuals need, while struggling to get the most out of every penny. At the same time, many younger people are struggling to care for their children and parents, while working full-time jobs—a stressful situation even on the best of days—leaving everyone concerned feeling frayed and frazzled. This is where social workers come in to the picture…
Social workers can help. Working with families who need assistance finding adult day-care programs, dealing with the stress of caregiving, or figuring out financial problems, social workers can point people in the right direction. By providing resources and helping older individuals understand the opportunities available to them, social workers help clear up confusion and relieve stress.
Social workers also help aging individuals by:
 Counseling seniors and their loved ones to help them maintain good mental health, relieve stress, and avoid anxiety and depression;
Assisting older individuals in preparing for doctors' appointments;
Helping families plan ahead to identify care options (such as assisted living or long term care);
Guiding seniors as they navigate the complex Medicare system (and other confusing health-related issues, like insurance);
Talking with families to find out if they need legal assistance or financial counseling;
Providing resources to help older individuals find the information and assistance they need.
Aging is a time of change for both older adults and those who care for them. It can be stressful at times, but it's also a period of growth and opportunity. With help from professional social workers, seniors and their loved ones, friends, and communities can come together to create a healthy and vital environment for seniors.
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IntroductionRenee is a working professional with a husband and child. She and her immediate family live in the Southwest region of the country. She has recently been informed by her aunt's physician that she will need to come to California to take care of her aunt Louise.
Louise is in her mid-90. She has recently started to experience a major decline in her health and mental status which has affected her ability to care for herself. She is living with her husband who is a retired physician. Both have managed to take care of each other until her husband experienced a minor heart attack two month's ago. As a result he has a pacemaker and is taking medications for his condition. Upon discharge from the hospital, the husband has also shown a decline in his mental status and has become increasingly forgetful. Meanwhile, Louise complains about her inability to sleep at night and difficulty in walking around the house.
Renee, because she lives out of state, was recommended to a Licensed Clinical Social Worker who specializes in working with families and older adults. Together the two worked on hiring caregivers to supervise and assist her aunt and uncle during the day, as well as at night. In addition, the Social Worker assisted in re-connecting the aunt and uncle with their primary care physician by ensuring they made it to their appointments, as well as made sure their physician was aware of the uncle's medication needs. The Social Worker was also able to arrange to have both evaluated and assessed at a nearby geriatric assessment center to determine what plan and treatment could be followed for managing their decline in their mental status.
Within two months, both aunt and uncle are doing better medically. Although they still require home care workers in assisting with some of their basic needs, their mental status has stopped declining. Renee's uncle now goes out with a friend once-a-week to play golf and her aunt has returned to her routine of walking through a nearby mall while accompanied by her paid care provider.
Renee has been able to visit her aunt and uncle three to four times during the year without feeling guilty. Through the assistance of the social worker, Renee feels a sense of peace having a professional oversee the care and treatment of her relatives. This help has increased her relative's ability to stay in their own home and improved their quality of life.
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Alzheimer's Association
The Alzheimer's Association is the world leader in Alzheimer research and support, is the first and largest voluntary health organization dedicated to finding prevention methods, treatments and an eventual cure for Alzheimer's. Its mission is to eliminate Alzheimer’s disease through the advancement of research and to enhance care and support for individuals, their families and caregivers.
www.alz.org
Your Local Area Agency on Aging
At your web browser type "area agency aging + {city}
National Association of Social Workers
The National Association of Social Workers (NASW) is the largest membership organization of professional social workers in the world, with 153,000 members. NASW works to enhance the professional growth and development of its members, to create and maintain professional standards, and to advance sound social policies.
www.socialworkers.org
Register of Clinical Social Workers
The NASW Register of Clinical Social Workers provides a listing of clinical social workers that have met national standards for education and experience established by the NASW Competence Certification Commission. The NASW Register lists clinical social workers at two levels of experience and expertise: the Qualified Clinical Social Worker and the Diplomate in Clinical Social Work.
http://www.naswdc.org/register/default.asp
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Do Not Be Afraid to Ask For Help
Whether it is human nature, or fear, we tend to wait until we are in crisis before asking for help and consultation. To further compound our problem, we sometimes avoid going to professionals that are trained and experienced in handling our long-term care situations.
TIP: Seek a referral to a trained and licensed clinical social worker.
It Is Not Easy to Tell Your Parents What to Do
The most difficult thing about caring for a parent is the day you have to tell them they need to have help, they can no longer drive, they can no longer write checks, and they may have to move into a "home for the elderly".
TIP: Discuss long-term care wishes and desires before the decline happens.
Take Care of Your Mental Health
It is not unusual to feel frustrated and angry with your parent when they refuse your input and help. Even though you want to plan and adhere to their wishes, it is hard to do when they don't "trust" you with all of the information, especially when it comes to the financial aspect. No matter what the history and interpersonal dynamics consist of, you will always want to be sure to take care of your own mental health.
TIP: Seek a referral to a trained and licensed clinical social worker who can help you with your personal issues and frustrations.
Keep Informed
We live in a world of constant change. Medications and treatments are constantly changing and the only way to keep up-to-date is to stay informed with the latest news.
TIP: Attend local caregiver conferences, participate in support groups, speak with friends and relatives, and talk with professionals in the field of gerontology and geriatrics.
Laugh
Humor and laughter are tremendous healers. Sometimes we need to take time away from the serious aspects of our daily lives and laugh a little (or in some cases a lot).
TIP: Go out with friends to a comedy club, balance your movies with one of those "silly and stupid" movies, and balance your conversations with other discussions besides caring for your parent.
Hire Help
Do not be afraid to hire and pay for help in the home. Seek out professionals that you can trust to help you carry out your desires and meet your needs. It is not necessary to pay an excessive amount of money for help, but it is important to seek out value for the dollars expended.
TIP: Use recommended home care agencies, visit assisted living facilities at different times of the day and week, talk with friends about their experiences – word of mouth referrals tend to work better, and interview professionals before deciding upon the one you are going to retain.
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Preparing for a Doctor Visit
With the increase in the number of older adults living longer, comes the added pressure on our current medical system to manage these growing numbers. To help the patient prepare for a physician visit, it is recommended that time be taken ahead of the appointment to ensure that all of your questions are responded to by the primary care doctor. 1) bring your medications, or a list, of all medications and supplements; 2) write down any problems you are experiencing from the medications, such as dizziness, headaches, insomnia, etc; 3) write down questions you have regarding treatment or specific therapies; and 4) write down the responses to your questions.
Physical Activity
We know that physical activity that provides a minimum of 30 minutes a day is just as important as eating a healthy diet. Physical activity is not only healthy for the muscular and skeletal system but has been found to help decrease the onset of depression, as well as helps to reduce stress. In addition, exercise can help to minimize weight gain and can help with some sleeping difficulties. Naturally, before engaging in any type of physical activity we strongly recommend talking with your primary care physician first, as well as during subsequent follow-up visits regarding your regimen.
Psychological Related Issues
Depression and Anxiety – Both depression and anxiety are treatable. It is not unusual for individuals to experience changes in their mood as their life changes. There are many unexpected events that take place that we are not always prepared to handle such as a loss of spouse, siblings, or friends. There is no need to fear seeking professional advice from a trained and licensed professional social worker who is prepared to assist you in managing these new life changes.
Caregiver Stress – One major reason a family member ends up residing in skilled nursing is because of caregiver stress by the primary caregiver. It is important to recognize the signs and signals, seek professional help, or join a specific caregiver support group. Many times caregivers will experience some of the following: an increase in frustration, headaches, sleeplessness, loss of appetite, feelings of anxiety, social isolation and separation from friends, and increase in chronically related health problems.
Maintaining a Healthy Brain – As we age, there is the fear that we will become increasingly forgetful and eventually develop some form of a dementia. To help prevent the early onset of a dementia, or Alzheimer's disease, "exercising" our brain on a daily basis is recommended. Simple activities such as having a discussion with friends on world and national events, crossword puzzles, word games, board games, card games are some suggestions. Physical activity, attending social events, the theater, movies, and concerts can also be helpful. Avoid spending long hours watching television passively by incorporating an exercise routine at the same time. Also keep in mind that a healthy diet can also lead to a healthy brain.
Social Related Services
Family Support – Reconnecting and maintaining family connections is of particular value as we grow older. This may be the time to address the issues that separated the family through the use of a trained licensed social worker who specializes in working with families. Perhaps it would be better for family members to begin this healing process in order to garner support for each other at this time when things seem to be going well instead of when there is a crisis or death in the family.
Adult Day Programs – Social interaction with age appropriate peers can be enjoyable for those who may not even like to socialize. Many state supported programs exist which offer a variety of services for the elderly. Senior centers offer organized activities for the independent adult, adult day programs can provide the necessary relief or respite care of someone who is experiencing signs of early onset dementia, and adult day health services provide a comprehensive list of medical and social oriented services for persons living on Medicaid.
Senior Services – There are a wide range of human and health services for persons within all economic ranges. There are programs that can help people who might otherwise be placed in a skilled nursing facility to stay at home and there are services for families experiencing living with someone who has a dementia-related disease. Some families benefit from working with a trained geriatric professional care manager who can help with identifying resources and navigate through the issues of helping an aging parent or family member.
Financial Related Services – Paying for care, especially if you want to continue living in your current environment can be just as expensive as living in an assisted living facility. Many families may choose to utilize their existing home to pay for care through a reverse mortgage or equity loan. It is recommended that before considering such an action that the family engage the services of a professional care manager to assess the benefits and your capability to remain in your home first, followed by the discussion as to the best way to fund the plan of action. It is best to discuss long-term financial planning with a certified financial planner, as well as your accountant.
Medicaid Long-Term Care – The funding of Medicaid is currently in flux with potential changes in financial qualifications under discussion. Eligibility is determined by meeting specific financial requirements. The program is intended to provide care and treatment for those who are in financial need and in some cases may not have enough income to cover the cost associated with a long-term care facility. Professional social workers can answer questions regarding eligibility qualifications and benefits through this government-funded program.
Legal Related Services – It is highly recommended that individuals, regardless of their income/financial status, consider composing a Living Trust or will. With these documents individuals can discuss with an attorney an estate plan that will help protect the family's assets, as well as designate whom will have responsibility for making legal decisions if the person becomes unable to make decisions for themselves based on health issues. Typically included in these documents is a Medical Directive that provides specific instructions as to your desires and wishes if you become incapacitated to make such decisions.
Care Management Services
Services to help you implement a plan of care will be based on your decision about where you want to live. In many situations, families may want to consider hiring professional geriatric care manager/social worker and paying for the services provided on a fee-for-service basis. Before selecting a care manager you may want to first consider your preferred long-term care goals. He or she can help you select a home care agency and identify an assisted living facility.
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Living at Home / Community Living
Based on current trends, families and individuals will have more options available to them with respect to where they spend the remaining time of their life. As the aging population continues to grow, unlike the past, more and more older adults are moving closer to where their adult children and grandchildren reside. As new communities are developed there will be a greater trend towards comprehensive living arrangements whereby single-family homes will include "in-law" units to accommodate an aging parent. In addition, more states will begin to adopt special certifications for facilities housing persons with dementia-related diseases. The current trend towards increased development of Assisted Living Facilities will continue, however more of these facilities will be more comprehensive in design and include a variety of levels of care that would include independent living, assisted living and skilled nursing all on the same property.
Aging baby-boomers are going to continue to set the trend for healthy lifestyles into their "golden age." Many physical and nutritional products will become more noticeable in the coming years. This is evidenced by the growth in yoga and Pilates classes which places an emphasis on creating flexibility and strength in joints and limbs while also developing the needed neurological responses to help keep our mind and body in sync. With the added research and education offered to current aging adults on healthy diets there will be resurgence on the value of healthy food products. Along with this will be the added value of vitamins and supplemental products to help slow the aging process. Furthermore we will continue to see persons living longer and retiring later. In some cases there will be older adults willing to work part-time in order to keep active and involved, as well as meet growing financial needs. Senior volunteer opportunities will also increase in a variety of settings including museums, zoos, hospitals, and even within assisted living facilities. As we experience greater longevity there will be increased demand for recreational and social activities that involve age appropriate social activity. There will be an increase in the number of group vacation plans for persons over the age of 65 who are socially active.
There is a current trend towards connecting the aging population with information through the Internet. The Internet is highly useful to provide the general consumer information on health concerns, how to find a physician, understanding their medications and side effects, and to help in identifying resources. There are new products coming out utilizing the Internet as a method to monitor the activities of a parent when no one else is in the home providing care or supervision. In addition, technology will be developed that will help us keep in higher contact with our physicians and family.
Another notable trend will be the emphasis on having caregivers who are trained to manage and care for our aging populace. Some facilities require professional caregivers to earn a specified number of continuing education credits to show that they are qualified to care for persons with dementia-related diseases. With the increase in home care costs, many families are going to want to examine how care providers are trained. Since there will be more public knowledge of possible elder abuse and neglect, many families are going to demand that trained, bonded, and insured care providers are placed in their parents’ home.
With the use of the Internet, consumers will become more educated on the use of prescribed medications. Consumers will continue to explore the use of alternative medications, such as herbal and nutritional supplements. This will also lead to the growing trend of certain medicines added, or removed, from the available list as drug interactions and side effects become better known. They will also seek out information from their local pharmacist in order to understand side effects and possible alternatives to the drugs they are taking as an alternative to getting the information from their primary care physician. There will also be an increase in the number of geriatric social workers, physicians and psychiatrists available who are prepared to answer and respond to the growing questions related to the changes associated with the aging process.
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