Senior Home Care Ohio

Cleveland Ohio Elder Care

Help with ADL’s May Reduce Health Care Costs Among Elderly

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by Kevin K. Johnson, CSA

“Older people who do not have help for daily tasks such as dressing and bathing are much more likely to be hospitalized for acute illness than older adults who received the help they need”, according to a Purdue University study that dates back to 2006. Their study also “found evidence that older adults who qualify for nursing home care because of their disabilities in daily tasks, can continue to live in their homes provided they receive assistance with fundamental needs such as bathing, dressing and preparing food.” Elders who lived alone without such needed assistance were more likely to require hospitalization. After a few weeks of help with daily tasks, however, the need for heath care dropped off, implying that a little help with the basics goes a long way.

Nearly 30% of adults age 75 and older have one or more disabilities in performing basic activities of daily living. The Purdue study found that people who have difficulty with Activities of Daily Living (ADL’s) including bathing, dressing, and walking across a room need the health-care system to a greater extent. Those who have trouble with ADL’s have higher rates of hospitalizations, longer hospital stays, and more physician visits that those with no disabilities.

Well over $130 billion is spent each year in the United States on long-term medical care, about 73% of which goes to nursing homes. Half of long-term care is paid by the government. Keeping a person in a nursing home costs the government over $30,000 per year, while paying a home care aid to visit for a few hours a day would costs perhaps a third as much. Additionally, they receive the added quality of life that comes from remaining in their familiar home surroundings.

Findings of this type are the basis of many of the efforts to reduce the cost of long term care. With the increasing numbers of elderly over the next 2 decades, every effort will be made to provide great service to our seniors at the best price point possible. Home care has proven to be a win-win-win solution.

Family Conflict in Caregiving

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written by Kevin K. Johnson, CSA

For almost 10 years we’ve been working with families to provide eldercare for their loved ones. One of the issues we continue to see is conflict in the very family structure where the senior is in need of assistance. More often than not, these issues are not financial. Instead, they have to do with family ‘case management’. Put another way, what family member is in-charge; who is the ‘general manager’ for the elder loved one? For example, we have seen life-long sibling relationship problems come to the fore when trying to work through critical caregiving issues for a mother or father.  

The Alzheimer’s Organization added that “family members may deny what is happening or resent family members who live far away or are not helping enough. There may also be disagreement about financial and care decisions.

To minimize conflicts, we concur with the following comments from Alzheimer’s* organization. 

Have a family meeting. Talking about caregiving roles and responsibilities, problems and feelings can help ease tensions. You may want help from a professional counselor or clergy.

Recognize differences. Some family members may be hands-on caregivers, responding immediately to issues and organizing resources. Others may be more comfortable with being told to complete specific tasks.

Share caregiving responsibilities. Make a list of tasks and include how much time, money and effort may be involved to complete them. Divide tasks according to the family member’s preferences and abilities.

Continue to communicate. Periodic family meetings or conference calls keep the family up-to-date and involved. Discuss how things are working, reassess the needs of both the person with Alzheimer’s and the caregiver, and decide if any changes in responsibilities are needed.

* Alzheimer’s Association (www.alz.org)

What is Long-Term Care?

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written by Kevin K. Johnson, CSA

After last month’s blog, “Costs of Long-Term Senior Care”, I received a few questions of a similar nature. “What constitutes long-term care? Sometimes we want to believe that there is a pre-existing baseline of understanding, but often this is just not the case. So let’s talk about Long-Term Care.

Long-Term Care (LTC) Defined

Generally speaking,  long-term care is a requirement, perhaps a required outcome that results when injury or disease keeps an individual from taking care of themselves for a long period of time. ‘Long period of time’ is somewhat subjective, but actuaries have been able to address this in general terms for purposes of providing insurance.

When Would Long-Term Care Be Needed?

The U.S. Department of Health and Human Services tells us that:

  • At least 70% of people over age 65 will require some lone-term care
  • Of those who need long-term care, 40% are under age 65

An individual may need assistance as part of the normal aging process, or they may have a medical crisis such as:

  • Stroke
  • Multiple sclerosis
  • Diabetes
  • Alzheimer’s disease
  • Rheumatoid arthritis
  • Vehicle accidents

Any serious injury or illness with long-lasting effects could keep an individual from performing the tasks necessary to sustain their independence. These tasks are referred to as activities of daily living (ADL’s) and include:

  • Eating
  • Taking a bath
  • Getting dressed
  • Moving in and out of bed
  • Grooming
  • Using the bathroom

When an individual needs assistance with ADL’s, long-term care comes into effect.

What Are the Types of Long-Term Care?

Either in your home or in a facility, as stated above, long-term care refers to any kind of support for activities of daily living on a long-term basis. These types of long-term care services can occur at any location, for a person of any age.

If in the home, care can be delivered by:

  • Personal Care Assistants or Companions: Assistance for household tasks like cleaning, cooking, running errands
  • Home Health Aides: Assistance for personal care like bathing and dressing
  • Nurses: Assistance with medications, IV’s, and more complex health issues

If in a facility, the range of care levels includes:

  • Adult Day Health Care: Providing daytime social and therapeutic activities, while still living at home
  • Assisted Living: Enables an individual to live with a degree of independence with on-site support for daily basics
  • Nursing Homes: Providing more skilled and intense care, supervision, medication, therapies, and rehabilitation

In my next posting I’ll expand on options that can be put into play to assist in being prepared for Long-Term Care.

Costs of Long-Term Senior Care

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written by Kevin K. Johnson, CSA

In this last blog post of the year, I thought I’d take a look at the 2011 cost for various types of long term care for seniors. Every year, MetLife’s Mature Market Institute publishes figures from regions across the United States. The following is an overview of national costs along with average costs in the state of Ohio for various types of long-term senior care.

Nursing Homes — Daily private-pay rates for long-term (custodial) nursing home care were obtained for private and semi-private rooms in licensed facilities throughout the United States.

National average rates for a private room increased by 4.4%, from $229 daily or $83,585 annually in 2010, to $239 daily or $87,235 annually in 2011. National average rates for a semi-private room increased by 4.4%, from $205 daily or $74,825 annually in 2010 to $214 daily or $78,110 annually in 2011.

For 2011 in Ohio, the average cost of a semi-private room is $199/day; the average cost of a private room is $223/day.

Assisted Living Communities — Monthly private-pay base rates, which are defined as room and board and typically include at least two meals per day, housekeeping, and some personal care assistance, were obtained for one-bedroom apartments or private rooms with private baths in assisted living communities.

National average assisted living base rates increased by 5.6%, from $3,293 monthly or $39,516 annually in 2010, to $3,477 monthly or $41,724 annually in 2011.

For 2011 in Ohio, the average cost of assisted living is $3372/month.

Home Care Services — Hourly private-pay rates were obtained for home health aides from licensed agencies and for agency-provided homemaker/companion services.

The 2011 national average private-pay hourly rates for home health aides and homemaker/companion services remain unchanged from 2010 at $21 and $19 respectively.

For 2011 in Ohio, the average cost of Home Health Aide is $19/hour.

Adult Day Services— Private-pay daily rates were obtained for adult day services. Adult day services national average daily rates increased by 4.5% from $67 in 2010 to $70 in 2011.

For 2011 in Ohio, the average cost of Adult Day Services is $55/day.

Costs for Nursing Homes, Adult Day Care,  Assisted Living Costs, and Home Care for specific regions of the state will be reviewed in the first quarter of 2012. Regions around Ohio’s big cities tend to have prices at or above the national and state average figures listed above. Additonally, I’ll talk about the differences between these types of senior care services and when you and your loved one might consider one type of service versus another.

Happy Holidays to you all!

Know Yourself. Know Your Environment. No Falls!

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Written by Kevin K. Johnson, CSA

With 2 octagenarian parents having multiple chronic diseases and mobility issues (both use canes or walkers), I am constantly speaking with them regarding the issue of fall-prevention. I’ve worked with them to remove or secure rugs and furnishing that might cause a problem. We’ve installed grab bars in the appropriate areas. Recently they agreed to have a stair lift installed which has proven to be a big help to them. The Ohio Injury Prevention Partnership published this information that I’ve applied with my parents. If you have fall concerns regarding seniors, I think you will find these concepts useful.

From the Ohio Injury Prevention Partnership

Falls and fall-related injury seriously affect older adults’ quality of life and present a substantial burden to the Ohio’s families and health-care system. Among older adults, falls are the leading cause of injury-related deaths and the most common cause of nonfatal injuries and hospital admissions for trauma. Most bone fractures experienced among older adults are caused by falls. The most common fractures are of the spine, hip, forearm, leg, ankle, pelvis, upper arm and hand.

The Ohio Department of Health (ODH) reports that falls among older Ohioans have reached epidemic proportions, and account for a
disproportionate share of fall-related injuries. In 2005, older Ohioans accounted for 20 percent of all fall-related emergency room visits and 81 percent of deaths, despite representing only 13 percent of the overall population. According to the Centers for Disease Control and Prevention, 30 percent of Americans age 65 or older living in the community, and more than 50 percent of those living in residential care facilities or nursing homes, fall every year. The risk of falling increases with age.

Prevent Falls
You can reduce your risk of falls by following five easy steps:

1. Increase your physical activity. Simple exercise, like walking or swimming at least 15 minutes a day can help build muscle strength and improve balance, which can prevent falls. If you are unable to participate in these activities, ask your doctor for other types of activities that could help build your strength and balance.

2. See your eye doctor once each year. Age-related eye diseases, such as cataracts, macular degeneration and diabetic retinopathy, can increase the risk of falling. Early detection is key to minimizing the effects of these conditions.

3. Review your medications. Talk to your doctor about the medicines you are taking and whether they may cause drowsiness or dizziness. Discuss things you can do to ensure you are taking your medicines safely.

4. Remove environmental hazards. Look around the house for anything that could increase the risk of falls, including poor lighting, loose rugs, slippery floors and unsteady furniture. Remove or modify these hazards. Identify areas where additional lighting, grab bars and other safety support are needed.

5. Think, plan and slow down. Many falls are caused by hurrying. Slow down and think through the task you are performing. Be mindful of
possible falls risks and act accordingly.

Individuals and families also can contact their area agency on aging or local health department office to learn about available trainings and resources designed to reduce the risk of falls. Call toll-free 1-866-243-5678 to be connected to the area agency on aging serving
your community.