How Does A Private Caregiver Handle a Sick Day?

One of the negative things I hear on the forums about hiring a private caregiver is, what do you do when you count on that person and they cannot come to work for one reason or another? Being a caregiver is not like other jobs were you can miss a day and the work will wait. People need you to be there. Many people use this as a reason to knock down the idea of private caregivers. I would like to share with you how things worked for me on one case I had two years ago.

The woman who hired me was a very smart successful business woman. She wanted to hire a private caregiver for her father in law (me) so he would have consistent care and could form a relationship with his caregiver. When hiring through an agency, having consistent caregivers is a real challenge because of the agencies high turn over rates. Plus the rates of the agencies are very high.

I was hired to work full time Monday - Friday and every other Saturday. However the daughter in law realized there would be times when I would need a day off or be sick and so she set up the best working arrangement I have ever seen. 

She hired an agency to be the back up. The agency director met with her so they would be familiar with the case. They then agreed to furnish caregivers for the weekend when I was off and also for any days I was ill or needed a personal day.

The arrangement worked like a charm. Although I missed only a couple of days during my time with them, it was nice to have the safety net the agency provided. Perhaps you are a private caregiver. What arrangement  has worked for you? How do you handle the times when you need a day off? I would love your input as we all learn and benefit from the exchange of information. Please feel free to leave a comment or contact me.

Until Next Time

Nancy

Helping A Senior Downsize? Pack Your Patience!

Hello All, 

It's snowing again....It's march 3...ugh, Wanted to share with you a story about downsizing a senior.

When my aunt was getting up in years it became apparent that living alone in her house was no longer a good thing. She was not really sick, it was more of a financial burden for her to keep her house and the neighborhood she lived in was getting to be more dangerous for someone living alone. With the help of my mother the decision was made for her to move into a subsidized senior apartment building. She did not have a large house, but still it was a big downsize for her.

I was young at the time and so I volunteered to help her go through everything and I do mean everything in her house so she could pack up what she wanted to take and say good by to the rest.

Thank heavens I was a patient person. I remember going room by room, drawer by drawer, closet by closet sorting and sorting every scrap of paper, every plastic bag every stack of paper, I thought it would never end.

So here’s the thing. Older folks and probably many younger ones too collect a lot of stuff.  When we live in the same place for any length of time we, like birds fill our nests with thousands of bits and pieces of STUFF. Whether it’s books, papers, clothes, nick knacks, food, whatever we have lots of stuff! This holds true for the majority of the population with the exception of those who are minimalists like my sister in law ( she does not even have a junk drawer ) who doesn’t have a junk drawer or 10? 

For those of us who are younger, when we decide to move what do we do? We load up dozens and dozens of boxes with all our STUFF! We don’t take time to sort it all out ( at least most don’t ) we just shove it in a box label it “Office” and load it on the van, only to be unloaded at our new digs and shoved back in the drawers from whence it came.  And so the process goes each time we move from the time we leave our parents home till the time we find ourselves old and have to relocate to a smaller nest. 

Now you see this move is not like the others. We cannot take all our stuff with us. But how do we decide? Our nest has been so comfortable for so long, how will we live without ALL our stuff. It’s hard let me tell you. And the older you are the harder it is. I worked with my aunt helping her sort through her stuff for over a month. Some days it was painstakingly slow. We would perhaps get through only a dresser or a closet. I watched as she handled each and every item she owned and had to make the choice, take or abandon.  I could see how hard it was for her. Things that I thought were meaningless seemed so important to her. In my heart I knew I had to let her make the decisions and could not rush her to much.  We finally got through everything in the house and boxed up the things she was taking with her only to find, it was to much stuff. So we had to pare it down a bit more. The move went smoothly and soon she was settled in her new nest surrounded by the things she has chosen as most important to her. She lived in that apartment for several years until the time came when she had to move to a nursing home. This move was very different as she had developed dementia and so now it was my mother and I deciding what she could take. That was very hard, but in the end we chose the things we thought would bring her a sense of home, photos, a favorite clock, a little purse to keep some odds and ends in. I think we chose wisely, she seemed happy and this move meant getting rid of most of her stuff, that was a sad day. 

In the end I learned some very valuable lessons. 

• Giving up our Stuff is hard and with all the other things older folks may have already lost like their independence, their home, their car, their health, and now this….it only adds to their pain.

• Downsizing before you are forced to do so is a good thing. Perhaps we should all take a look around as I am right now. Look at all the stuff we have. Do I need to thin in out a bit? Maybe 5 junk drawers is enough instead of 10 or maybe pare it down to 1!

• In the end things aren’t  what mean the most in life. I know it’s cliché but family, friends, relationships that is what matters in life, all the rest is just fluff.  

So if you are helping a parent or another loved one or friend downsize be patient. Stop and think “what if it were me” how would I feel about emptying out my nest . That will help you help them though this very tough and often painful process.

Have you helped someone downsize? I’d love to hear about your experience and how you survived the process.  We are on this journey together and learn from each other so please feel free to share.

Until Next Time

Nancy

When Searching For Assisted Living Beware of Hidden Fees

Hello everyone, 

I hope you are enjoyed your weekend. I had my granddaughter here today, she is almost two years old and she wore me out, but it's a good kind of worn out. Children bring out the best in us and keep us young - or so I hope.

Today I thought to share with you some of my findings on the HIDDEN FEES that are lurking in some if not all Assisted Living Facilities' pricing structures. This came to mind after I was reviewing a checklist that AARP put out for people who are searching for an Assisted Living facility. What was it that was so surprising?

What is a Care Agreement or Contract and Who Needs One?

Hundreds of people maybe even thousands today are caring for a senior in their home or even taking them into their own home to care for them. Most of the time this is a family member. When faced with caring for a loved one often times a person has to give up work or retire early in order to care for their needs. This may put a financial burden on the one providing the care. To help compensate them for the loss of income many family members chose to pay their caregiver either from their own income or savings or by using funds provided by government benefits. 

If this is the case for you or someone you know you should consider putting a care agreement or care contract into place. But what is a care contract?

How Many Days Does Medicare Pay for In Nursing Home or Rehab After Hospital Stay?

Hello All,

I was on the senior care forums these past few days and one of the threads was talking about how many days are covered by Medicare in a Nursing Home or Rehab after a hospital stay. The answers were all over the map and quite confusing I must confess, so I thought I would do a post about it to clear things up. I have always told my readers I am no expert, but when it comes to this subject I know it all to well. You see mom has been in and out of rehab 3 times in the past 2 years so we know the rules by heart.

According to Medicare rules a person must have a qualifying hospital stay of at least 3 days 
( 24 hours) and be in need of further skilled nursing or rehab care in order for them to pay for the stay. The doctor and the physical therapy department at the hospital must agree that the patient would benefit from continued care or therapy at a nursing home or rehab facility. 

It is important to note at this point that the patient needs to be an inpatient at the hospital for 3 days, and time spent in observation or the ER does not count. They have to be admitted to the hospital. This is very important!

Procedure for Setting Up VA Fiduciary Account for Mom's Benefits

"It Really Was Quite Easy and Painless. "

Hello All,

Today we finally had the meeting with the rep from the VA to set up the Fiduciary Account for mom's Aid and Attendance Benefits. As promised I will tell you all how it went and what I found out about the process. 

The meeting was very informal. We met at the Adult Family Home where mom is now living. The rep needed to meet with my sister who was to become the fiduciary and my mom, in order to assess her abilities to handle her own money. I went along to see how the process worked and just in case there where any questions about her application since I was the one who filed the initial forms.

The rep was very nice. She asked my mom the usual questions when checking for dementia; Do you know what year it is? Do you know who is president? Do you know where you are? Have you been in the hospital in the past year? Mom was able to answer some of the questions but with further conversation and my mom's own admittance, it was obvious that she needed help and could not manage her money on her own. 

The rep then gathered required information. She needed copies of my mother's financial  statements, bank accounts and any other sources of funds. She needed verification of my mother's current monthly income - social security and any other sources besides the VA benefits. A list of her current medical expenses was also needed - medicare supplement premiums, and lists of medications and cost of care at the Adult Family Home. Then she asked for two references from my sister who would testify to my sisters trustworthiness. She also asked for my sisters approximate yearly income.

After gathering all the information she went over the process for setting up the account. My sister will receive a letter of approval from the VA after they complete a background and credit check on her.  She then needs to take the letter along with a direct deposit form which the rep gave her to the bank and have them set up the account. The account will be in my mother's name with my sister's name listed as fiduciary. She said any bank can be used. Once the account is set up the back payment that is owed to my mother will be deposited into the account and her regular monthly payments will start going into that account.  

Here are a few rules about how the account is to be handled:

•  My sister will have to write checks from this account directly to the Adult Family Home, she cannot transfer the money into mom's other account and write one check, she will have to write two checks every month.
• There is never to be any commingling of funds with any of my sisters own money. The money is to be used only to pay for mom's  care ( already knew that ).
• My sister must keep records of all expenses in case they were to ever audit the account. Not hard since it's money in money out kind of situation.
• We are to notify the VA if mom moves or goes on medicaid anytime in the future. 

Other than that it was pretty straight forward. The meeting lasted about 30 minutes and she wanted to see my mother's room before she left. We were glad to get this piece of the puzzle in place so that from here on out things should be straight forward. 

By the way, if someone has ever filed for bankruptcy they cannot be a fiduciary for another under the VA rules. 

Hope this helps you if you are facing this procedure in the future. It really was quite easy and painless. We are very grateful to have these benefits for mom as they allow us to have her in a nice quiet place with some wonderful people looking after her. Without the VA we would have had to apply for medicaid and then the uncertainty of where she would end up would have been an issue. We will have to apply for medicaid in the future if she out lives what she has left but at least this buys us some time (about 4 years) to see what our options are without having to make a hasty decision we may regret. 

If you are in a situation like ours, I suggest that you take the time to research medicaid facilities, as I will be doing, over the course of the next several months. Find out what facilities take medicaid and if there is a waiting list. I find being proactive makes things easier and less stressful for all. 

Until Next Time
Take Care All,
Ruth Anne

New Study On Dementia Shows They are No Closer To Answers IMO

Hello All,

Hope this nasty blast of cold is not hitting you to hard. In Michigan it was another brutally cold day today, but the weather man says by the weekend 50's are forecast, hope Al is right.

"More education leads to less cases of dementia, yet we live in the most educated time of the past 200 years and then they say that the number of overall cases is going up."  -New England Journal of Medicine

A new study just published and referenced by NPR titled
"Can Dementia Be Prevented? Education May Bolster Brain Against Risk"
shows in my opinion that they are no closer to having answers about these brain disorders plauging the world. Here is some of what the article stated and then I will share some of my experience with you to prove my point. 

In part is what the article stated:


"The odds of getting Alzheimer's disease or other forms of dementia are declining for people who are more educated and avoiding heart disease, a study finds.- The results suggest that people may have some control over their risk of dementia as they age."

This isn't the first study to find that the incidence of dementia is waning, but it may be the best so far. Researchers looked at 30 years of records from more than 5,000 people in the famed Framingham Heart Study, which has closely tracked the health of volunteers in Framingham, Mass.

They found that the incidence of dementia declined about 20 percent per decade starting in the 1970s — but only in people who had at least a high school education. The decline in people diagnosed with Alzheimer's wasn't statistically significant, but there were fewer people with Alzheimer's, which could have affected that result.

Meeting with VA for Fudiciary Account Posponed a Week

Happy Saturday to all,

Our meeting with the VA rep to set up mom's fiduciary account was suppose to be yesterday. The rep called in sick so now the meeting is set for next Friday 2/19/2016. I was disappointed as I hoped to have information to share with you on how the process works, but this extra week with give you more time to send in your questions about VA Aid and Attendance Benefits. You can use the link at bottom of article or you can email me at ruthann@palcaregivers.com.

Hope to hear from some more of you as this is a great chance to get you questions answered by a expert, the rep, not me.....


Until Next Time
Take Care
Ruth Anne

Tomorrow is VA Meeting Remember to Send Me any Questions

Just a quick reminder, I am meeting with the VA rep in the morning to set up Fiduciary Account. If you have any question you want me to ask her about anything related to Aid and Attendance Benefits send them to me before 9am eastern time Friday the 12. 

I will try and get answers for you.