Senior Home Care Ohio

Cleveland Ohio Elder Care

CMSA’s 24th Conference & Expo

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by Kevin K. Johnson, Certified Senior Advisor (CSA)

 

VISIT WITH VISITING ANGELS

cmsa_logo_PMDid you know that  Cleveland, Ohio is one of only five U.S. cities with more than one hospital on the U.S. News World & Report Best Hospitals 2013-14 Honor Roll. Additionally, the Global Center for Health Innovation is the only one of its kind in the world featuring hands-on interactive displays depicting the future of health care. Well, this week Cleveland Convention Center and Global Center for Health Innovation will host the 24th annual Case Management Society of America conference. The conference starts Tuesday evening, June 17th and runs through Friday, June 20th. Visiting Angels will be participating in this year’s conference and exhibition. Please come visit with us in the conference exhibit hall at Booth #813. CMSA’s Annual Conference & Expo offers a high-powered mix of diverse education sessions, leading industry experts and valuable networking opportunities! This annual gathering allows case managers and allied health care professionals to come away empowered with the latest knowledge & information. We are proud to be a member of this community providing a trusted resource to seniors and those entrusted with their care.

 

iStock_SigningWill_PMADVANCED CARE PLANNING

Over the past years and as recently as the past two blog posts, I’ve discussed the importance of creating Advanced Directives and working through the tough job of Advanced Care Planning. These are difficult issues. They require patient persistence, tact, assertiveness, and resolve all at the same time. As a picture can sometimes be more effective than words, so too can a video show the challenges and the importance of addressing Advanced Care Planning, no matter how difficult, and getting through the process ahead of the possible occurrence of a major health issue. Please reference Cecilia’s Story as told in this informative YouTube video. I think you will find this beneficial for you and your family.

Long-Term Care Planning — A Sense of Urgency!

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by Kevin K. Johnson, Certified Senior Advisor (CSA)®

Here is a fact that should get your attention. The cost of long term care continues to rise at a rate that outpaces inflation!

BACKGROUND — At present, we have almost 12 million Americans in need of long term care services. From Wikipedia, Long-term care (LTC) is a variety of services which help meet both the medical and non-medical needs of people with a chronic illness or disability who cannot care for themselves for long periods of time. It is common for long-term care to provide custodial and non-skilled care, such as assisting with normal daily tasks like dressing, bathing, and using the bathroom. Increasingly, long-term care involves providing a level of medical care that requires the expertise of skilled practitioners to address the often multiple chronic conditions associated with older populations. Long-term care can be provided at home, in the community, in assisted living facilities or in nursing homes. Long-term care is a commonly focused for senior citizens.iStock_RetirementPlanning_PM

COSTS — Of the many options for long term care, the cost of receiving in-home care continues to be the most cost effective on average; its cost is increasing at a slower rate. This is a positive for seniors because the overwhelmingly want to age-in-place with “in-place” being their home. In light of the fact that the number of Americans over age 65 is projected to double over the next 40 years, continued increases in the cost of care and decreasing public financing options available to cover these costs, long term care is lining up to be one of the most important social issues of the first have of this 21st century.

According to Genworth, nationally, the 2014 median hourly cost for a home care aide from a home care agency is $19.75. Home health aide services have risen, on average, only 1.32% annually over the past 5 years.

The cost to receive care in an assisted living facility is rising at a much faster rate. The median annual cost for care in an assisted living facility is $42,000. This represents an increase of 4.29 percent annually over the past five years. The comparable cost for a private nursing home room is $87,600, which has increased 4.19 percent annually over the past five years.

Here’s the point; costs for long-term care is increasing year after year. Once you reach 65, there is a 70% chance that you will need some form of long term care services. That being a fact, it is only prudent that everyone apply considerable effort to creating a sound financial plan for managing their inevitable future long term care costs.

Let’s talk about the perimeters of a long-term care plan. You need to know that the average long term care claim current is about three years. Now working the math through the three prominent options what the resulting costs.

  1. In-Home Care via a Home Health Aid — nearly $136,000.
  2. In an Assisted Living Facility — nearly $143,000 and
  3. In a private nursing home room —over $260,000.

Now if we apply an inflation rate of just 3%, in 25 years, when many baby boomers will require long term care services, costs for an average length of stay in a private nursing home facility will be about $840,000, a huge expense that most of us will be unable to afford. Keep in mind that few workers have company sponsored time-honored pensions, and that their replacement vehicle, the 401(k) plan and the like, are badly underfunded by their individual owners. Also, most people don’t really realize that the government program, Medicare does not cover long-term care needs. Medicaid, provides a degree of coverage for long-term care, but only after life long savings have need nearly depleted.

WHAT TO DO? — For most Americans, private long term care insurance is one of the most viable and effective approaches to get prepared. But remember, long term care insurance is part of a comprehensive plan that should be developed as one part of your comprehensive retirement financial plan. Strongly consider augmenting your long-term retirement tools with one of several types of long term care insurance products.

Money is not the only issue with regards to long term care planning. It is critically important to remember that your long-term care planning needs to include specific directions and guidance for others in case you become unable to communicate those wishes yourself.

Advanced Directives — All adults can benefit from thinking about and planning for what their healthcare choices would be if they are unable to speak for themselves.  These decisions can be written down in an advance directive so that others know what they are.  Advance directives come in two main forms:

  1. A “healthcare power of attorney” (or “proxy” or “agent” or “surrogate”)  documents the person you select to be your voice for your healthcare decisions if you cannot speak for yourself.
  2. A “living will” documents what kinds of medical treatments you would or would not want at the end of life.

OHIO ADVANCE DIRECTIVEiStock_SigningWill_PM

  • The Ohio Durable Power of Attorney for Health Care lets you name someone, called an agent, to make decisions about your medical care—including decisions about life-sustaining treatment—if you can no longer speak for yourself. The durable power of attorney for health care is especially useful because it appoints someone to speak for you any time you are unable to make your own medical decisions, not only at the end of life.  Your durable power of attorney for health care becomes effective when your doctor determines that you have lost the capacity to make informed health care decisions for yourself.
  • The Ohio Living Will Declaration is your state’s living will. It lets you state your wishes about health care in the event that you become terminally ill or permanently unconscious and can no longer make your own health care decisions. Your Ohio Declaration becomes effective when your doctor determines that you have lost the capacity to make informed health care decisions for yourself and you are terminally ill or you are permanently unconscious.
  • The Organ Donation Enrollment Form allows you to register your organ donation choices with the registry, so that your organ donation wishes will be followed, even if your declaration cannot be found.

These forms do not expressly address mental illness. If you would like to make advance care plans regarding mental illness, you should talk to your physician and an attorney about a durable power of attorney tailored to your needs.

There are other advanced planning vehicles including ‘trusts’ that should be considered however, the basic elements of the advanced planning portfolio are what I’ve covered above. This is important and I urge every adult to proactively address advanced care planning today for the sake or yourselves and your families!

If you already have your Advanced Directives completed, I congratulate you. Just remember, as a matter of practice, to review your advanced planning documents annually. Your decisions and directions are subject to change by you, and you are certainly free to make modifications to your documentation as you feel appropriate. My advance is to use an attorney. Your family, who will be impacted by your advanced directives, is too important to leave to have a misinterpretation cause an unintended outcome.

Like the title of this blog suggest, have a sense of urgency with regards to your long-term care planning.

Thanks to Wikipedia and Genworth

Dementia: and “One More Thing…”!

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by Kevin K. Johnson, Certified Senior Advisor (CSA)®

OK, dementia is such a huge topic that once I get started on it, I always think of “one more thing…”! So, as a follow up to my last blog post where I elaborated on the various forms of dementia, here’s my latest, “one more thing”….

iStock_Dementia_PMWhat should you consider doing when you observe the very first sign of memory loss in an elder loved one; if you receive a formal diagnosis of dementia from a gerontology focused medical professional? Remember, dementia’s are regressive chronic illnesses. The memory loss will continue at an unknown and unpredictable rate.

If you are like so many families there has been minimal, if any, discussions on what to do in case your elderly loved ones becomes incapacitated. At the advent of  cognitive deficiencies, this is a conversation that has to take place immediately. You can no longer allow your elder loved one to think of themselves as totally independent and self-sustaining. In many cases, it takes a jolt, such as a dire medical diagnosis, to motivate seniors to have ‘the talk’; cooperating and sharing in the details of their financial assets along with their explicit wishes for how they want their affairs handled. In any event, you have to move into a ‘managed care’ mindset with deliberate immediacy. Think  “Assets” and “Advanced Directives”!

If there are siblings, a determination must be made regarding who will be the designated individual(s) for financial and medical related issues. If you are lucky, the senior will make this choice, thereby eliminating  any debate or heated fellowship between siblings. These issues can be quite contentious in some families.

ASSETS — Without fail, make sure that the assets of your loved ones are not solely in their name. Working together compile a complete list of each and every, bank accounts, investment accounts, mortgage, deed, insurance policies etc… Become the designee on bank accounts, mortgages, etc… Remember, if there is a another person legally on the account that individual has access to the asset. You can also use a ‘beneficiary’ designation on these assets whereby upon death, the designated person has access to the asset.

PASSWORDS — Don’t forget about electronic access from sources such as bank accounts to websites such as Amazon. Identify and document everything.

Now, let’s talk about Advanced Directives.

ADVANCED DIRECTIVES — Legal documents that allow you to plan your own end-of-life wishes known in the event that you are unable to communicate those thoughts later.

Living Will — An advance health care directive, also known as living will, personal directive, advance directive, or advance decision, is a set of written instructions that a person gives that specify what actions should be taken for their health, if they are no longer able to make decisions because of illness or incapacity. A living will is one form of advance directive, leaving instructions for treatment. The living will is the oldest form of advanced directive. A living will usually provides specific directives about the course of treatment that is to be followed by health care providers and caregivers. In some cases a living will may forbid the use of various kinds of burdensome medical treatment. It may also be used to express wishes about the use or foregoing of food and water, if supplied via tubes or other medical devices. The living will is used only if the individual has become unable to give informed consent or refusal due to incapacity. A living will can be very specific or very general. Consider the ‘living will’ as the fundamental building block of a comprehensive advance directive plan. But advanced directives have evolved well beyond the living will.

Power of Attorney or Health Care Proxy — The next layer of the advanced directives foundation is the power of attorney or health care proxy, in which the person authorizes someone (an agent) to make decisions on their behalf should ever be rendered incapable of making their wishes known. This may or may not be the same person selected for financial responsibility. People are often encouraged to complete both documents to provide comprehensive guidance regarding their care. The appointed health care proxy has, in essence, the same rights to request or refuse treatment that the individual would have if still capable of making and communicating health care decisions. The primary benefit of this second layer of advance directives is that the appointed representative can make real-time decisions in actual circumstances, as opposed to advance decisions framed in hypothetical situations, as recorded in a living will.

Medical Directive — The next widely recognized third layer advance directive is the Medical Directive. This is usually a six-page document that provides six case scenarios for advance medical decision-making. The scenarios are each associated with a roster of commonly considered medical procedures and interventions, allowing the individual to decide in advance which treatments are wanted or not wanted under the circumstances.

TAKE ACTION NOW!

So there you have it. A comprehensive approach you should action, ideally before a crisis occurs, to assure that the wishes of your elder loved ones are fulfilled. Using these tools helps to assure that there are few unknown issues regarding money and finance, property, or specific medical care requests. Although there are do-it-yourself options available, I strongly recommend working with an attorney that has a practice in estate law or eldercare to prepare and file the documents. Mistakes in the paperwork can prove to be frustrating and costly at a time when you need as much calm, order, and predictability as possible.

April 16th is National Health Care Decisions day. It’s the date set aside each year to encourage everybody over age 18 to discuss and plan ahead of a serious illness. I encourage everyone to do just that. This is not a subject of exclusively for seniors. As the commercial goes “…life happens fast”! Completing advanced directives should be a requirement for everyone once we reach the age when we are considered an adult. Once completed, the documents should be reviewed every 24-months to remain consistent with the personal wishes that may change as we go through life. If you haven’t done so already, use April 16th as a day of action and complete your Advance Directives. Your loved ones will be glad you did.