Wednesday, December 21, 2011

Caregiver Considerations for the Holidays: Part 2 - Gifts for Seniors

Finding gifts for seniors is hard. I've always been amazed by the way many seniors have simplified their lives, many without realizing they're doing it. In part it comes from the comfort of falling into daily living routines. Developing routines is often a luxury caregivers, specially those with children, rarely have so it can be a difficult concept for some to grasp. Seniors also have a way of simplifying the things around them. Even the 'pack rat' types tend to use the same tools for daily living, whether they enjoy being surrounded by the 'stuff' of their past, or not. So they don't 'need' or 'want' another kitchen or gardening tool, and some are frankly so picky, they won't wear the new slippers you buy them because they aren't just like the worn out comfy ones they wear now. The 'new isn't always better' mindset often challenges those purchasing gifts for their beloved seniors. For many seniors, novelty items like IPads and cell phones truly don't have the joy that a new pair of socks do. It's hard for those of us managing with our younger 'gadget' generation to imagine.  It's also hard when we ourselves still like modern surprises to appreciate the simplicity of new socks in the favorite brand we've always worn. So what do you give your beloved senior?  Here are a few ideas:


Spend time thinking about your loved one's lifestyle: 

Some are loathe to admit that finances are tight. Some are up front about it. In either case, you can identify ways to meet the needs of daily living if you're willing to look for them. There's where you can help by gifting to meet needs but in a way that maintains dignity. 
  • Does Dad complain about the price of his favorite snacks?  Make him a basket of his favorite goodies.  Put it in a small laundry basket he can carry when you notice he has trouble managing the large one. 
  • Does Gran avoid going shopping with you when she used to love to pick out clothes?  It may be that she doesn't have the money or mobility she used to, or both. Give her a gift card for the store along with a handmade coupon for the ride to get there. You've met needs (for financial and mobility support) while letting her maintain her dignity. 
  • Does Mom often 'run out' of necessary household items then have to scramble for change to reimburse you when you pick them up (or not offer to do so at all?).  Then a gift card to a store is a good thing and think of throwing in the gas money and time to get her there. 
  • Who doesn't bemoan the cost of gas?  It may not seem like a 'real' gift, but a gasoline card can give your beloved senior the freedom to go somewhere he or she has wanted to go.
  • Gift certificates for movies, art classes, or ticket to a theatre show in town may give your loved one the luxury of entertainment they've not considered for themselves because they aren't part of their daily living routine.  Such gifts can give them a refreshing change of pace.
  • Have you noticed that no one in the family will eat Aunt Sue's cake anymore because of the cat hairs in it? (Really, that's happened- Aunt Sue forgets that the cat sleeps on the counter and can no longer see the cat hairs!) Tell Aunt Sue you'd like to give her the gift of doing some baking for her this year. Set a time where you come to her house and she provides the ingredients. You clean up the kitchen and cat hairs while baking with her. The time together as well as the pride she has by bringing that cake to the family gathering (or garden club meeting) is a gift (for all!).  Make a cute gift certificate for it - box it and wrap it!
  • Is cleaning the house a chore?  Surprise mom with a gift certificate for a carpet cleaning, or your own coupon book for chores that are likely easy for you to do but most difficult for her.  Consider coupons for: cleaning out the fridge, organizing cupboards, dusting the ceiling fans, replacing light bulbs, and attic organizing days. For your own sanity but a fun but important note across the bottom:  this coupon is valid only with 1 week's notice of redemption. 
  • Does Mom forget important dates? Don't just give her a calendar, put the important family dates in it for her!
  • For caregivers, giving the gift of time off-duty is priceless and becomes a two way gift. The giver and recipient both benefit.  One woman, caring for an ailing husband, had health challenges herself. The woman's son brought her Christmas decorations out of the attic, but did not offer time to put them up. The friend, who'd wanted to find a way to help, offered to come put up the tree and 'watch' the husband, while her caregiving friend ran some needed errands. Though not wrapped in a box with a bow, this was definitely a gift. Offering caregiving friends respite coupons for a couple of hours at time is priceless.  
When it comes to giving gifts to seniors, it's not about the gadgets, the cost, or even the novelty of thought.  Being aware enough of their world and its needs is gift in itself.  And if all else fails... try the socks.

Best wishes to all for very Merry Christmas and Happy New Year!

Friday, November 18, 2011

Caregiver Considerations for the Holidays - Part 1

Connecting with Seniors during the Holidays
 
            Before you head into the express lane for holiday planning, take time to consider the concepts of re-wrapping and re-gifting as ways to connect with special seniors in your life. 

            Re-wrap your priorities to include the seniors in your life. They can miss the joy of the season by not engaging in the hustle and bustle their bodies seem less equipped to handle than in years gone by.
Family members and friends, traveling in the fast lane of the holiday hustle, often leave seniors behind during this season.Family gatherings can feel strained or obligatory for all, leaving the heart out of the events that are shared.

            Food, faith and fun are key concepts when reorganizing how you plan for your holiday season to include your seniors. A major key is thinking and planning head to make it work. 

            Make an appointment for your senior to come over for a cookie baking day. Many families already have 'baking days' but in the hustle and bustle they can leave grandma, grandpa, an aging aunt or neighbor out of the recipe. Set up the cooking area to make accommodations if needed. Move the cookie dough rolling into another room if Gramp’s wheelchair can roll there more easily. Add a pillow to the stool in the kitchen so Aunt Sue can help with sprinkles. The stories that will flow over the icing are sure to add flavor to every cookie, and the day. 

            Before planning that big holiday meal, share the stories of how the food traditions and favorite recipes traveled down the family tree. Call up the relatives from a distance or plan an interview time for relatives nearby. Let children help make recipe cards to share with family members. Setting time aside for children to start a recipe books with Grammi’s special holiday treats in mind will create a legacy they in turn will gift to their children. Grandma might not be able to do the baking anymore, but will enjoy tasting the treats her grandchildren made from her recipes!

             Just as you might have to dig for recipes, seek the deeper meaning of how your aging loved ones connect with the season that centers upon faith. Use family discussions, phone calls and special outings to enjoy the spiritual connection to the time of year - far away from shopping malls. Plan ahead to attend specific services that hold meaning for your aging loved ones, whether they are held at your own church or not. This provides a source for connecting with the past while planting memories for the younger generations where the focus isn’t on presents. 

            Plan a day where you ask an aging loved one (even the in-laws) what his or her childhood traditions were for celebrating the spirit of the holidays. Re-establish or re-live those traditions. In today’s traveling society, we often miss the connections to our faith roots. Plan a trip to visit the church that Grandma attended as a child and let her tell you and your family how holiday celebrations were held there. A trip down memory lane can be an incredible gift to a senior.

            By making an effort to plan time with the special seniors in your life into your holiday schedule, you’re participating in generational re-gifting and seasonal fun. Whether memories shared over cookie dough cut-outs, the stories told on a family outing, or the flavor of the recipes handed down through the generations, these no-cost gifts, shared between the generations keep giving.

 Author's note:  I'm interrupting the Hot Topics series to give you some thoughts for the fast approaching holiday season ... Hot Topics in Care and the Community Initiatives series will return though!

ACTION NOTE:  Caregivers, the enrollment/change period for Medicare coverage deadline is December 7th.  Take time to review your loved one's coverage and benefits to see if they match their current and future benefit needs. Make sure you review all parts of the coverage to ensure the best hospitalization, general medical, and prescription coverage!

Wednesday, October 26, 2011

Hot Topics in Caregiving 3: Community Care Initiatives - Faith Community Nursing


Most caregivers are thrown into the heat of the caregiving fire by an emergency situation and have little time to look for what resources are available. Take time to look ahead and see if any of the community care initiatives, reviewed in the next few posts, are available in your community and how you can access their benefits.

Faith Community Nursing (FCN):  This concept has been, and still is, known by many names: Congregational Nursing and Parish Nursing and Church Nursing are just a few.  But in 2005, the American Nurses Association changed to this standard term to better reference the non-denominational nature of the concept.

The practice of FCN focuses on the protection and promotion of health, prevention of illness, injury and disease, and alleviation of suffering within the values, beliefs and practices of a faith community.

The FCN definition above means there is no set “picture” of any FCN program, which is actually a great thing. It means that programs can be tailored to each community; and they are.

A faith community is a group of individuals brought together by shared beliefs.They are similar to a family and come to know needs within the group. A faith community becomes a starting place to offer help to those in need. FCN programs are non-denominational and don’t always have ties to a specific faith group, yet may be housed in a church, synagog, or temple, offering space for the ministry.They are programs that intentionally minister to both the health and spirit of an individual, while being nondenominational.

There is an interesting relationship that has developed between faith communities and medical practitioners. I’ll illustrate this by giving you a brief picture of FCN in my own community. 

One of the two main hospital systems in our community realized that by having a link into the faith communities, they could help promote wellness, reduce unnecessary emergency visits (often by un or underinsured patients) and in turn, reduce costs, help the community, and let the community know how they can offer other services. Taking education and wellness initiatives door-to-door wasn’t where to start. But find a group of people already working together who know one another’s needs and you have a place to build a point of service within a community. Building service then builds reputation and then when medical services are needed, where do the patients go?  In its simplest form, from this top (hospital system) down (to community) approach, it can be a marketing tool. But read on - it’s much more. What I’ve learned about the leaders in any FCN program is that they are CONNECTORS, linking people in need with services, becoming a hub for information flow. They are embedded in the community and know what’s available, and even more importantly, know how to access those services. It works in other ways too, as doctors will refer patients to the FCN programs to help them find additional support for their ongoing care needs. 

Caregiver check:  Call your local hospital to find out if they are connected with a faith community nursing program and ask what services are provided. 

There are many FCN programs that do not have a connection to any particular hospital too.  Community leaders will start programs or partnerships to unite care providers in different specialty areas to reach out to faith communities and facilitate wellness. There are many interfaith initiatives that use faith networks as a way to get information to community members about services available to them, whether free blood pressure checks, mammograms, or other preventive services.

Programs also start within individual faith communities when members of that community identify a need and seek resources for filling it. It may be diabetes prevention, blood pressure checks, or other forms of health screening. They then look to the larger community and its resources to fill the need. For example, if a church leader has been ministering to a number of congregation members who are suffering with uncontrolled diabetes, he or she may seek resources within the community to help address the issue at that church, not just for that individual.

Caregiver check:  Call the church local to your caree, even if he or she is not a member, ask if they have any health ministries, what they are, and how you can plug into those services. If they don’t, ask if there are any that do. Don’t let a lack of connection to a place of worship hold you back.  Church communities do welcome the chance to minister to others as an outreach.  

Meals on Wheels, a nation-wide nutrition outreach program, finds its community home in many churches and reaches from there into the community regardless of any denominational or faith belief (or non-belief) of its meal recipients. Such is the same with faith community nurses. They realize that a faith community is a place to start in offering health and wellness services to others. In my community, the Mobile Meals program actually started a nursing ministry, hiring nurses to provide support to meal recipients. They are in turn, supported by the FCN leaders. In this case, the Mobile Meals nursing ministry has provided community case management services for 2,000 daily meal recipients.Though not all Mobile Meals programs do this, it's certainly a best-practice that is making a huge impact on many lives and one possible because of the FCN program.

Caregiver check:  If your caree is receiving meals, ask the delivery person or agency if there are any other services that can be accessed in the community through their service.

Whether it is one volunteer in a specific church, a team of nurses offering services in many faith communities, or a hospital led program that has dedicated staff to filling healthcare needs within a community, all the models work to make a difference. They’re not going to replace a doctor or become your personal home health aide during a medical crisis. But they will connect you to services in your community.

So we know that FCN programs can look different, but what do they do? Let’s look at some scenarios:
  •  In one case, a woman’s husband was dying and she needed respite care. Through the FCN program, volunteers in a local church willing to help were identified and trained through the FCN program. The volunteers then took the lead on scheduling visits to the home to sit and visit with her husband so that she could have a couple hours break time a few days a week. All were volunteers, yet it was the FCN coordinator who knew where to start calling to get the woman’s need filled.  
  • A church member became concerned about the possible spread of flu with so many people gathering for worship during the height of a terrible flu season when vaccines were limited. The FCN program was able to get her educational materials about prevention techniques that could be shared throughout the church.
  • The Universal Medication Form (UMF) became available and used as a tool for reducing the number of errors in medication usage by individuals that was causing avoidable emergency room visits. FCN nurses worked within 100 different faith communities in their county to distribute the forms and teach people how to use them.  
  • The FCN coordinators trained community volunteers willing to teach a teen pregnancy prevention program within faith communities. 
Looking for Faith Community Nursing programs may be an answer to quickly connecting to resources within your community, and especially for long distance caregivers, may be the most efficient way to determine what is available when a loved one needs care.

The International Parish Nurse Resource Center offers a worldwide LIST (by State) of program coordinators.

Many thanks to Georgia Lanford and Jenny Holmes, leaders of the Spartanburg Regional Congregational Nursing program for providing me a wealth of information that I in turn have shared with you.

Thursday, October 6, 2011

Hot Topics in Caregiving 3: Filling The Donut Hole

Simply glazed, iced, or with sprinkles… donuts have holes. Education may help you keep from falling into a very sticky and expensive one or help you climb out of it sooner.  

One hot topic for both caregivers and seniors is the Medicare Prescription Coverage “Donut” Hole. The simplest explanation is that this is the point at which coverage from Medicare part D supplement stops paying for prescription costs after a certain limit is reached and then the point at which it starts to cover them again. According to multiple sources, the amount not covered can be about $1400. Some patients never reach the hole. Others discover they’ve fallen into it when they go to pick up their medications from the pharmacy receiving a bitter pill to swallow. But it’s no joking matter. This can be a life threatening issue when seniors have to decide whether to pay their rent, buy groceries, or stay on preventative meds they can’t afford if they plan to eat. About.com offers a general overview of the issue in a June 30th ARTICLE.  

The bottom line is self-education and self-awareness. Sometimes it’s the caregiver that must be the one to step in and increase awareness in order to help prevent problems. If you’ve never asked your caree about his or her insurance coverage and limits, now’s the time. If you’re a caregiver who is not involved in the financial issues of your caree, then at least make the recommendation that all insurance coverage issues be reviewed with the goal of preventing unexpected bills.  

Start with a copy of the insurance policy. Find out what’s covered, what’s not, and when there are any holes in coverage. If you don’t know the coverage benefits and limits, you or your caree can request that a copy of the policy (if one can’t be found) be sent to you so that you have the facts. Find out if the policy runs on the calendar year Jan-Dec, or some other term. If there is more than one insurance policy, find out where the coverage overlaps, and which company is responsible for the bill first. Check to see how this affects prescription coverage too. If two policies renew at different times then paying deductibles becomes confusing. Sort through these issues before you end up with an unexpected bill.

Next, review your (or your caree’s) medications. Find out what the policy you have does and doesn’t cover. How much do those meds cost monthly? Can generics be substituted to reduce cost? Do the drug companies offer discounts, coupons, or other support for patients with financial need? If so, what is the process for proving need.

Next look at an EOB: Explanation of Benefits. They come in the mail from insurance companies and they let you know where you stand. Compare your numbers to theirs and keep records. Keep receipts of what is spent both at the doctor’s office and the pharmacy in copays and deductibles. Find out what the dollar amounts are for the limits of coverage and when any gap is likely to occur. Some policies have higher premiums which reduce the size of the donut hole, but it’s often still there. Will you reach the hole before your coverage year renews? If so, can you put aside some money now to cover the gap?

A few things to consider:
  • Even if you review your current medications and feel you’re unlikely to hit the gap, consider the costs of medications that may be needed should a hospitalization occur - are you prepared?
  • It takes time to prove financial need when asking for aid from a drug company. The sooner you know what your need level is and what documentation is needed, the sooner you can get help.

  • Talk to your doctor about the issue. A standard medication for preventing certain health conditions may have alternatives. Don’t expect your doctor to anticipate your financial needs. He or she is there to treat you medically. Although some may ask about your coverage and be sensitive to the issue of medication cost, it’s not likely to be foremost on a doctor’s mind when writing your prescriptions.     

Caregiver’s Golden Nugget 1:  While you’re reviewing insurance coverage issues for your caree, look over yours. Whether or not you qualify for Medicare yet yourself, it’s important to understand your own insurance issues and what kind of coverage you'll need when you have those decisions to make.

Golden Nugget 2:  While the terminology for deductibles, limits, and non-covered items are fresh in your mind, apply that knowledge to a review of all your policies - homeowners, renters, vehicle and long term care.  

Thursday, September 22, 2011

Hot Topics in Caregiving 2: Case Management

Having served as a volunteer and untrained case manager for my parents’ health issues for many years, I learned much being thrown into the fire of the complexities of modern medicine. Most caregivers do end up in the management role, often with great frustration, but there is more help available for that role than many realize.

Professionals trained in case management can be hired to pull all the resources available together, making the most of the medical community you or your loved one can access.The catch is that most are not covered by insurance.That happened to be one of my soapbox issues offered to the recent meeting with Hallie Hurst who feeds such issues back to Washington.

Using resources efficiently should be of interest to all - and worth the investment. I have no doubt the savings of streamlining resources would more than cover the cost and thus should be included in Medicare and other insurance benefits, saving all money and time. Hopefully, this will happen, but in the meantime, such services should not be immediately discounted due to cost. Some medical practices have even started absorbing the cost of having an on-staff case manager to help their patients, so be sure to ask your doctor if s/he offers that assistance.

Geriatric Case Managers may offer a free consultation if you are considering using their services.The majority of GCMs, often certified in their field, do not have access to billing options that insurance might cover.  

Whether or not there is an insurance company to be billed, it is wise to at least look into such a service. The National Association of Geriatric Case Managers helps link provides to clients. A recent ARTICLE by Reuters News agency highlights times when case management can be helpful. Consider the fact that geriatric case managers work with many clients and are local.That means that the longer they are in business and the more professional affiliations they have, the more resources they know about and can access for you.hey also know the right person to call within each office and which forms need to be filled out for what service. With the wealth of programs and resources available (they ARE out there!) it helps to have someone on your side who already knows what’s available and what’s worth your time pursuing. Consider the value of the time you’d have to take off work to handle all the issues that come up while starting from ground zero and trying to catch up.  

The Distance Factor

Now consider the plight of long distance caregivers. Mom and Dad live hours or states away but you want to help. Deteriorating health or sudden illness has made it clear that they need assistance, but you have a full life no where near them and have no knowledge of their community resources.If they cannot afford case management services for themselves providing it may be one way you can help.

Case managers help prevent individuals from racking up “frequent flyer” points with hospitals.Industry professionals actually used that term to describe patients that repeatedly return to the hospital, usually through the emergency department, because their care is not managed and they are not able to do it for themselves.If an outside party can intervene and organize multiple types of care to address complicated health issues, there is a reduction in avoidable hospital visits.This means savings for the medical and insurance communities, a huge stress savings for patients and families, and better overall care and well being for the patient.

A note of caution:  Realize that pricing for Geriatric Case Management services vary greatly by location and the types of services offered/needed.Try not to discount the idea by hearing of a base rate of $80 or more per hour, which you’ll find if you do a generic online search. Dig for what you can find in your (parents’) community and ask if they offer a free initial consultation. At the very least, you find a service you don’t need now, but might need in the future.You’ve done the legwork ahead of time and can prepare! At the most, you’ve found the answer for ensuring your loved one’s quality of life despite medical conditions you can’t cure. 

Friday, September 9, 2011

Hot Topics in Caregiving 1: The Cost of Futile Care


This week I attended a focus group meeting led by Hallie Hurst, field representative from Congressman Trey Gowdy’s office. Those of us in attendance each shared our insight from our various professional perspectives regarding senior care issues.The goal was to make sure that the concerns of the group were passed on to Washington - a wonderful opportunity! Over the next several posts I’ll get into those hot topics of care with you. Some we’ve touched on before, but now have a new light shed on them; others are new.

Today’s topic: Futile Care - It’s a term caregivers don’t want to hear, but it is an accepted term within the medical community. It refers to looking at the “big picture” and death, challenging areas for caregivers. 

Nancy Dereng, who works with Community Outreach for Interim HealthCare, who has long been an advocate for Advance Directives (ADs), mentioned the high cost of futile care in medicine. The reference was that if more education is done regarding ADs and what the actual dying process involves, the more people would make choices that don’t involve trying every last medical technique or procedure at a time when they simply won’t make a difference in the big picture of the outcome for the patient. The cost is high for hospitals, insurance companies, as well as Medicare and Medicaid programs, not to mention patients and their families. But what also struck me was the great emotional cost attached to futile care. Nancy's seen it first hand, and works hard to educate people of all ages about options that make a difference.  

Are you tying your doctor's hands?
Nancy later shared with me the two main reasons that futile care happens. One is the threat and fear of lawsuits. It’s hard, she explained, for a doctor to say “there’s nothing more we can do.” That's emotionally hard to say and to hear, but in this day and time, there are things that can be done, whether or not the reality indicates they’ll made a difference. The availability of options is the second reason.

A point for patients and caregivers to consider is this: do you want to tie your doctor’s hands and force them to continue aggressive care measures by pressuring them to “just do something” when it’s your emotions that are talking and not a realistic view of the long term impact? If you say “do something” many physicians feel obligated to try something, even if they don’t feel it will make a big enough difference on the outcome. The lifeline you want isn't there. But, they don’t want a lawsuit. Just because something can be done doesn’t always mean it should be done. Unfortunately, the legal climate of our society doesn’t always make the differentiation between ‘can’ and ‘should.’

For Nancy, it comes down to weighing the benefits with the burdens of care. That's the discussion point. If a frightened caregiver or patient feels there could be a benefit to trying one more procedure, they often don’t consider, don’t ask, or don’t want to know, what the burden may be.

ADs take away some of the guess work and in many cases, futility. Understanding when a feeding tube is a real help, or simply a way to prolong the inevitable (with potentially more trauma to the patient), is important. All adults, whether they are seniors, caregivers, or not (yet), need to look at ADs. My favorite program for working through is process is called Five Wishes. Talk with your loved ones BEFORE they ever become an issue of decision making in a medical care situation.

Caregivers need to look at how they approach physicians as well. If you bring rope with you to tie their hands, you may well be making the situation harder for yourself, your family, and your loved one. Instead, give your doctor permission to discuss the burdens of care options when he or she may not feel 'safe' to do so. Ask what they are. Ask what the doctor sees as the big picture and long term prognosis. If you foresee a time when your emotions may get in the way, consider talking with the doctor, with your caree present, before it factors into decision making.  

I have been there. It isn’t easy. During one hospitalization for my father, I told the doctors I was concerned that the time might be coming when we’d need to say ‘enough is enough’ and look toward comfort rather than curative care. I asked them for honesty when that time came, and, if needed, a reminder I’d asked for that. One doctor appreciated it, saying he wished more caregivers would tell him that. Another said he understood, assuring me that he did not feel that time had come yet. A third, looked at me blankly and said, ‘okay.’ Dad’s ‘time’ didn’t come then, but did a few weeks later after yet another hospital stay. He was discharged to come home with hospice care. We all knew the decisions that were made were for my father’s best interest and so did Dad. We'd had the talks. Could the doctors have tried one more surgery? Perhaps. If they had though, it would have been an example of futile care involving a surgery that would have come not just with a cost in dollars to his insurance companies, but a much heavier cost to him, for the physical and emotional trauma of 'trying one more thing' and for his loved ones watching.

Caregiver Golden Nugget:  While you deal with these issues with those you care for, deal with them now for those who care for you. When you ask Mom or Dad what they want for end-of-life care, turn right around and let your spouse, your kids, and your best friend know what you want.

Friday, September 2, 2011

Closed Doors: Important Opportunities for Caregivers


One closed door.....
In the example I gave last week, a woman used a window of opportunity to access care for her husband after he’d come home from a hospitalization and she realized she could not care for him in that environment. Even after being home for nearly two weeks, he still qualified for rehabilitative care based on the recent hospitalization and related diagnoses. Let’s look at what can happen next. 

Because his underlying diagnoses are degenerative conditions, there is only so much that rehabilitation can do. Improvements might be made. Can he come home again? Perhaps. But what if he can’t? Many people find themselves in this precarious caregiver situation questioning what to do next when the rehab of their loved one gives them a window of opportunity to reassess the care environment and long term picture.

For the vast majority, the desire to ‘go home’ is what drives success in a rehabilitative setting. That’s a good thing. But what happens when the caregiver, perhaps a spouse or adult child(ren) realize that coming home won’t be the best option even if gains are made during rehab? Let’s face it - that’s often a heartbreaking decision to be made. When the reality finally hits that home care is not the best care option, it can feel as if a door is closed. Many caregivers feel they have failed. Then factor in the added guilt-inducing factor when the caregiver knows that care elsewhere will make his or her job easier. Ouch. Did I just admit that? How could I say such a thing? Have you heard those words in your head? If you’re in this situation stop beating yourself up. That closed door will open new ones.

Dealing with the disappointment that it can’t be at home is one thing. Blaming yourself for reality is another. Realize that when the door closed on home care, you have an opening for another way to provide care. Your job, whether taken out of love or a sense of duty, hasn’t stopped. The value of what you have to offer hasn’t lessened, in fact, it’s increased. The only thing that has changed is the environment in which you offer care - the picture looks different; but the need for what you have to offer hasn’t.

Now your work is to find the best care environment away from home. Only you, the experienced caregiver can do that. You are quite likely the only one to know all the nuances of care for your loved one and be able to find the best way to fit those into a facility care environment. Perhaps your caree loves music and the new environment must be one where music can be played, where CD players are allowed, and the singing of hymns is encouraged. Perhaps you need to find someplace that allows patient/residents to play a community piano. Perhaps you can find a place close to home, or more central to other family members wishing to visit. Does she need an environment that offers social activities? Or a weekly church service?
Opens new ones....

Does it matter that you’ll finally get rest that’s probably long overdue? Yes! This is a chance for you to recover (and quite possibly from offering in-home care for too long). As your loved one strengthens in rehab, and perhaps a long term care facility, you need this time of restoration. Reconnect with the things of your life that have been put on hold. When you, the caregiver, have a chance to build up your strength, the quality of the care you have to offer, no matter where it is given, improves.You'll find new energy and strength you can use when giving care in a new setting. 

Wednesday, August 24, 2011

Windows: A Caregiver's Salvation


Windows can bring fresh air into difficult care issues
I recently learned of a woman caring for her husband who brought him home after a hospitalization only to discover that his care needs were more than she could manage.  The concept of “rehab” care had not been discussed by the hospital doctor or by any discharge planner. Since the wife had already been caring for her husband at home and the issue that brought him to the hospital was resolved, he was cleared to go home.Yet like most people who leave the hospital, he wasn't as strong as when he went in. That was complicated by the fact that his overall health issues were degenerative.

However, it soon became evident that his care needs were more than she could provide. She was among the fortunate who already had a relationship with a social worker who had been involved with her husband’s care. The social worker was able to tell her that there was a ‘window’ option she could consider. There is a certain amount of time after a hospitalization where a patient can be eligible for rehabilitative care. It’s a window of time. At first, she was told it may be 14 days, but the social worker would confirm. Later she was told it was 30 days. When the caregiver heard of the 14 day time limit, the she knew she had to move quickly. She had the help of the social worker who knew how to start the process for qualification quickly. It was handled through Medicare and he was placed within a few days.

            There are a few different caregiver nuggets to glean from this example. 

First, involve others in your caregiving team. Caregivers should not go through their duties alone. Whether you’re dealing with private insurance, Medicare, or VA health benefits, determine what kind of social work services you can access - and use them. It may be that the benefit falls under counseling or mental health benefits. If so, don’t let that ‘label’ for ‘mental health’ stop you. Even if there is a co-pay for such a benefit, again, try to work out using it. It may be that it’s “Dad’s” appointment, but you go with him and get the information too, or share part of the session.

Make sure the social worker is one that deals with your specific area of need and is not just seeing every kind of patient. Granted, they’re trained, but some specialize in geriatric issues. Many “geriatric case managers” are licensed social workers. Getting insurance to pay for their services as “geriatric case managers” might not work, but, applying for payment or authorization of services based on social work/counseling may. This is when a little time and work on the front end of a situation pays off with lots of time saved later on. 

The next nugget is to look for windows. Many people assume that once discharged, a patient cannot receive services or referrals from the hospital. Whenever you leave a hospital setting, make sure to get the discharge planner’s card. This is the person who comes in to see if you need home health or any other services. You may only see this person once, but learn to recognize this role. If problems arise after a hospital stay, call that person. Let them know that home care is not working and ask if they can help you find other options for care or secure more services. It might not be a rehab placement, but it might be the addition of home health services to help with bathing when your loved one has trouble with that and you can’t do it yourself until he or she gets stronger. 

Windows are helpful. Caregivers don’t know all the windows they can open to get fresh air into a stressful situation. By involving others in a care team, not only can they educate you about the windows available to you, they can help you opened them.    

Golden Nugget for Caregiver: When your caree is in the hospital, ask the staff to run a TB (Tuberculosis test) upon admission. The results of a TB test are required before a patient can be placed in any kind of skilled care facility and they take 2 days to get results. Even if you don’t anticipate a rehab stay, as the situation above illustrates, you need to be prepared. If you leave the hospital before the test results come in, plan to go back to the records department (with healthcare POA in hand) and ask for a copy of the results. The results of the test are only considered valid for 30 days. Whether you think you need them or not, getting them may save you time when you need it the most.

Friday, August 12, 2011

Financial Abuse of the Elderly - Part 5 - Final Notes

Is it time for help?
Delving into financial exploitation of the elderly has been a challenge. I’ve heard and read story after story of terrible cases where seniors who deserve comfort and security have had it ripped away from them by family members and strangers. It is a serious problem. As a final note in addressing this issue, I want to take a step back and remind you that the open door for such often comes when a senior can no longer keep up with their own finances. Do they want to admit they’re having trouble balancing a checkbook? Quite likely, no. Financial independence is something is something they’ve held as a measure of pride for the majority of their lives. If it’s your parents, they don’t want you to know they’re having trouble. It’s not easy to admit that you need help at any age, let alone break down the leadership roles you’ve held for most of your life.
Indicators That It May Be Time for Help

  • Past-Due Bills are piling up or Mom says people are calling to tell her to pay a bill she thought she’d already paid.
  • Mom or Dad keeps claiming to not have enough money. Sometimes they are fine but saying such is an indicator they aren’t feeling as secure as they once were.
  • Financial patterns change:  is Dad giving more or less in the way of financial gifts? 
  • The solicitations for donations are out of control. This may mean Dad’s been sending out a lot of donations meaning more will come as his name is shared on mail lists.
  • Mail order boxes are regularly appearing. Some seniors don’t need to shop ‘til they drop but take comfort in TV/Catalog ordering. Feeling they can buy things can nurture a sense of independence even when then items are needed. Retail therapy affects seniors too!
  • A hospitalization occurs and no one is coordinating the ongoing payment of regular bills like the mortgage/rent, utilities, etc.
Family members can step in and help. The key there is maintaining respect and communication while offering help. Try not to let judgment cloud your sensitivity to a parent’s insecurity or discomfort with a need for financial help. If your family dynamics do not include someone willing, able, and trusted by all to step in to provide the help needed, consider a financial manager. These professionals are helpful when family members disagree about who should be the one to step in and help Mom with her finances after Dad dies (a common time when financial management becomes an issue). Having an ‘outside’ party responsible may ease tensions between siblings/parents who cannot find peace with handing it within the family circle. 


The cost of financial management services will vary depending upon what intervention is needed, whether it’s the management of an investment portfolio or balancing a checkbook when the only deposits come from Social Security. Take some time to compare your fear of the expense to the fear of what could happen if even limited resources aren’t managed effectively.

 Tips when looking for an elder financial manager:
  • Research availability, services, fees
  • Ask for references and follow up by contacting them
  • Review your preferences for monthly reports
  • Determine if tax issues need to be addressed by a different professional
  • Assess the limits of the service provider (some may not be certified to a level to provide investment advice, but can still help with some of your needs and put things in order so that you can take the right information to an investment adviser)
I’ve recently had the pleasure of meeting Amy Carrick of CARRICK CONSULTING. She offered a glimpse at the complexity of many senior financial issues as well as some simple steps for solving them. She is a Certified Senior Specialist and a Dementia Specialist. She recently did a radio interview (listen to it by clicking on the link on her "About" page).  The interview focused on scams targeting seniors. She’s also dealt with a wide range of financial management issues for seniors and the disabled. Though she said it’s an extreme case, one client actually brought her boxes filled with six years’ worth of mail that had build up for an aging adult unable to manage sorting his own mail. Not knowing might be necessary information for getting man’s affairs in order, she had to go through it all. But with her eye for detail and knowledge of what was important, she managed the task and helped her client. 

Caregiver Golden Nugget:  When you find there’s an issue of care that you’re not comfortable dealing with, give yourself a pat on the back instead of a guilt trip. Many caregivers beat themselves up if they can’t handle all the issues that come up. But realizing your limits is a gift to all. It’s there that you can take action and make a positive difference.  If you’re just not a numbers person and don’t feel comfortable helping Mom manage her finances, Bravo for realizing it!  Now you can do something:  find the right person who can.  

Friday, August 5, 2011

Financial Abuse of the Elderly - Part 4 - The Legacy Lottery


Scammers prey on those wishing to leave a cash legacy



Many times letters and calls come in saying a senior has won or can win a significant amount of money. Remember the old adage “if it sounds too good to be true, it probably is.”The window for scammers comes from the deep desire seniors have to either secure their future or leave a legacy to their loved ones. Often their worries or desire to feel valuable by being generous with others will lead a senior down a path they might not otherwise follow. Insecurity can wreak havoc with judgment. If a person does fall victim to a scam or thinks they may have made a poor choice, embarrassment often keeps them talking about the issue and getting help if lured into a trap.Consider the following:
 
Scam 1 - A ‘winning’ letter or phone call comes in from a person claiming to be ‘an agent’of the IRS, Federal Trade Commission, or businesses sounding  like legitimate or government offices. A. They may be claiming there is a ‘problem’ with your account that needs to be cleared up. B. They may calling to say you won a prize but need to pay the taxes/fees first.
What to do?
If a phone call, ask for the contact person’s full name, phone number, and employee number along with their supervisor’s number. Write them down. If you can’t write it down, tell them to mail the information.
Why? If a caller is not willing to mail you the information or pressures you to take action now, it’s likely a scam. They may be trying applying pressure with a ‘limited time’ for prize redemption, followed by a fee requirement to ‘redeem’ the prize. They are looking for a credit card number so that processing can “begin immediately.” Though not all ‘prize’ calls are lotteries, remember that in legitimate lotteries, it’s the winner who makes the contact to collect their winnings. Lotteries don’t contact you. If they do, it’s likely you never entered in the first place and you’re about to be scammed for the cost of shipping or insuring your prize. 

Scam 2 - Wiring to Help
Beware of anyone asking you or a loved one to wire money in order to redeem a prize or in an effort to ‘help’ another person bring their money into a US account from a foreign country. This is a common scam that targets the elderly. Seniors want to help others - it builds their feeling of self-worth. If they think they might earn a helper’s fee in the process, it feels even better. There are many email (and phone) scams offering to pay a person a portion of the money for helping with transaction. Watch out for requests to wire money for any reason or give bank account information to anyone saying they need to ‘use’ your account so they can deposit into it. A related scam involves people claiming to hold the inheritance from a 'long lost relative' and they need your account information to send the money to you.

Scam 3 - The Intelligence Game
Another scam is one that preys on a senior’s ability to feel ‘smart.’ A game of some kind comes in the mail or through email. Players ‘win’ the right to move onto the next level. Their intelligence is validated. They ‘win’ several levels and then there are fees for playing the next levels where prizes are awarded. Somehow, they never quite reach that ‘winner’s’ status though and they’ve willingly paid for the chance, often multiple times.

Caregiver’s Golden Nuggets: 
The biggest thing to keep in mind here is that if you’re worried about a loved one falling victim to a scam, ask yourself ‘why?’ Do you think Mom is worried about her financial security and could be lured into such?  There is the issue. Talk about long term security.
Do you think Dad’s self esteem is falling because he doesn’t feel he has a legacy? Encourage him to realize that his legacy has nothing to do with money.
Look for the reason for your concern and you have found an opportunity to strengthen your bond, help your loved one relieve insecurities and fears, and develop a positive attitude toward the future.
  • If you think your loved one is a ripe target for scams, take time to talk about it but tread lightly so he doesn’t try to dig in his heels and try to prove himself with an “I’ll show you I know what I’m doing,” mentality. 
  • One gentle approach is to bring up concerns with an outside reference.  “Wow Mom, I heard/read about a scam going on now.  I can see how people would be taken in by it. It’s scary.”
 

Friday, July 29, 2011

Financial Abuse of the Elderly - Part 3 - THE DONATION DEBATE


 Now we’re moving from financial abuse of the elderly in the home to abuse and exploitation coming from outside sources.  It will take a few posts to just get the highlights of this complex issue out, so I highly encourage you to dig deeper, especially if you feel you or a loved one is at risk.

The Donation Debate

Junk mail often brings validation to the aging
One thing that makes the elderly a more ready target for financial exploitation is that they want to be useful and helpful. Whether it’s by mail or phone, solicitations from legitimate and non-legitimate organizations claiming to need help gives a senior’s self esteem a boost. Perhaps they’ve been incapacitated and can no longer participate actively in service to others but hey, they have a little money, why not help? Some feel that giving to others financially is the only way to contribute to society and they feel a weight of responsibility to do so. Telemarkers and Scammers know this well. 

Add to this the fact that many seniors have hearing and visual impairments. The small print isn’t visible and the ‘small print’disclaimers offered by phone callers are said so fast that even those without hearing problems have trouble understanding all that was said.  
             
If you’re the caregiver and you feel that your loved one is at risk for such, talk with him/her about donation boundaries. Ask your caree to set up a limited amount for yearly donations to outside charities and keep a log of what was given and when. This can be done to track donations for end-of year deductions, and even if your senior does not itemize, this often seems a reasonable request. If multiple request for payment come in, then you’ll spot them and have the evidence to share with your loved one.

            At one point, my father received multiple ‘bills’ for a donation he’d committed to over the phone. Tracking payments became difficult for him and when we realized he’d ‘paid’ his donation three times in one year, we knew something had to be done. He realized then that the organization was not as reputable as he’d thought and he stopped giving to them.

Caregivers struggle with the fact that for many seniors, the mail is sacred. For some, it’s their only link to the outside world. Mail from anyone on the ‘outside’ of their shrinking world feels like a validation of their importance. Some caregivers will try to be the ones to sort through the mail before their carees so that junk mail and unwanted solicitations for donations could be disgarded, before ever reaching the hands of their caree. But often this is impossible or a point of contention for caregivers and carees. Asking for limits and to be allowed to help can relieve tension.
  •  Ask your caree to put all donation requests in a single pile or basket that you help him/her go through once a month. While you or s/he makes the decisions and writes the checks or has you write them, put them in the donation log.
  • When calls are made asking for phone donations, ask your caree to tell the caller that either 1) s/he handles all donations through church, or 2) I only give to organizations willing to mail information.  If a caller don’t want to mail you a request or more information, it’s likely they just wanted to get you to give them your credit card number. Don't 'buy' that they want to save mailing costs... they're paying for people to make those phone calls! 
  •  To limit the number of solicitations coming in, make sure your loved one is on the national DO NOT CALL registry.  This limits phone calls both for soliciting donations and sales.  Make sure that both home and cell numbers are placed on the list.  http://www.donotcall.gov/
  •  You can also limit the amount of ‘junk’ mail and donation solicitations coming in the mail by at  http://www.directmail.com/directory/mail_preference/faq.aspx  to get information about how to get your name and address removed from many direct mail lists.
  •  The Direct Marking Association also provides this information for consumers who wish to be taken off mailing lists. When you register, your name and address are placed in a "do not mail" file which is updated monthly. DMA members are required to update their lists at least quarterly, and some do it monthly. Businesses who are not members of the DMA may also take advantage of this "do not mail" list, so registering with the DMA will reduce much of your junk mail. Register online. You may also sign up online at the DMA's website. There is no fee for online  registration. Visit:: https://www.dmachoice.org/dma/member/regist.action DMA says this option is quicker than by postal mail.

Register for the Mail Preference Service by mail. Send a letter plus a $1 check or money order to:
Mail Preference Service
Direct Marketing Association
PO Box 643
Carmel, NY 10512
Click here for their simple mail-in form, www.privacyrights.org/Letters/jm1a.htm.

Caregiver's Golden Nugget:  These resources can work for you too and help you clear out your mail box and stop getting unwanted sales calls! 

Friday, July 22, 2011

Financial Abuse of the Aging - Part 2


Do hired caregivers have access?
Just after bringing up the topic of financial abuse of elders, a front page story of my local newspaper featured the arrest of a paid caregiver who had stolen thousands of dollars from her caree by writing checks and using a debit card from her caree’s account.  The caregiver was hired from a very reputable company to provide in-home care while the caree was living in a senior residential community. 

Last week I didn’t touch much on the hired caregivers, but focused on the home front. However, often strangers we hope to become trusted helpers become part of the home environment. When hiring caregivers from agencies or from word-of-mouth referrals, ask for references and check them out. Take the time.  

The amount of employee screening varies between agencies, so when hiring a caregiver using a company, ask how they screen and check their employees. Find out what their policies are if an employee is found to be defrauding a caree and check liability. A background check done at the time employment is made doesn’t keep that person from becoming a first time offender if the right opportunity arises, so it is important to be proactive. If you are hiring privately, do your own background check. 

Some family members are so relieved to find an agency to help; they feel they will ‘hurt the feelings’ of the staff by asking about such policies. Always remember that if you are hiring a caregiver, he or she is your employee. If you’re going through an agency, that agency is your employee. Remember that for agencies and private duty caregivers, this is a business. Treat it as such.

Often, in the rush to find help for in-home care after a hospitalization or other emergency, family members are just relieved to find someone to help and don’t take time to ask important questions. That’s just when the door for potential abusers is opened.

When family members live far away from their aging loved ones, having a debit or other card accessible to a caregiver may be a necessity.  If so, consider the following:

  • Have a contract drawn up that the caregiver(s) signs acknowledging the appropriate uses for the card. 
  • Have an expenses log that must be filled out for each purchase. 
  • Reduce the number of bills coming into the caree’s home by having them forwarded to the person who can handle the finances.
  • Have bank statements sent directly to the person who will be monitoring accounts, not to the caree’s home where they can be ‘misplaced’ or ‘lost.’
  • Remove the need to have a debit card on hand by having a cash allowance and recording system for purchases and monitoring receipts.  
  • Write PLEASE CHECK ID above the signature on credit or debit cards. 
  • Plan monthly trips to help run the general shopping errands for personal items, reducing the number of trips a caregiver needs to make and fill Mom or Dad’s car up with gas so it’s ready for use.  (See Nugget Below)
Just establishing these practices, even if it seems like overkill, will send a message to any potential abuser that you and your loved one are not going to be easy targets.  

But isn’t this the person you are asking and trusting to care for your loved one? Yes. In the case noted above, it was the caree’s son who caught the funds missing from his mother’s accounts. Though the article didn’t say, it could be that his mother was receiving very good care for her physical and emotional well being and until the bank statement came in, there was no reason to suspect a problem. Again this reinforces the need to have someone financially trustworthy, and perhaps slightly removed from the immediate care situation, monitoring where money goes, when it goes, and for what purpose expenditures are made when the elderly are no longer able to do this for themselves.

If a new/potential hired caregiver truly has the best interests in their caree and their job, they won’t hesitate to sign contracts, review policies you establish, and be conscientious. If any potential hire, even from an agency, balks at the rules you establish, find someone else. 

There are times when it works well for a caregiver to have a debit card to a caree’s account; however, it is essential that a set of checks and balances be in place to monitor the situation. As mentioned last week, not even family members will be so conscientious and consider use of debit cards and cash left in wallets as ‘payment’ for their help. 

Finances in care situations should always be laid out clearly so that all parties involved are aware of expectations and boundaries. 
           
Golden Nugget for Caregivers:  Many times, hired caregivers use a caree’s car to drive him/her to doctors’ appointments or shopping. Two points to consider here.  First, the car needs gas. Think of either making sure the car is filled weekly/monthly yourself, or if the caregiver is allowed to use a card fill up the car, make sure you’re following up to verify that only the one car is being filled. Point Two: Check with your loved one’s insurance company to make sure there is coverage for a new driver or that the caregiver’s insurance will cover driving another person’s vehicle. Check the insurance limits to make sure that will not be a financial disaster waiting to happen.

Friday, July 15, 2011

Financial Abuse of the Aging - Part 1

Now we’ll get into the financial aspects of elder abuse which come on two fronts.  First we’ll tackle home base then we’ll get into the attacks from the outside world. 

We’ve all known people in our lives who are users. Whether they are also physical abusers, or not, they take advantage of situations and people around them for gain. Let’s face it - some of them are family members.      

 On the home front, a conscientious caregiver needs to talk to their aging loved one about finances. The sole purpose is for the caregiver to facilitate the caree’s wishes and long term security. If you’re getting involved for any other reason, please check your motivation. 
Unfortunately, some family members assume they should have control over a caree’s finances for the wrong reasons. There are also friends, when there are no family members available or willing who will step in and offer to “help.” Check everyone’s motivation. If you do not feel that your parent is being wise in his or her choice, talk about it. Family issues get sticky. But here are two points of fact that can help you take personalities out of the heavy issues.

  1. A person with a durable power of attorney can make financial claims. If that’s not someone you feel can trust to be around your wallet, make some changes.
One woman who was given durable power of attorney for her godmother called the credit card company asking to have a card issued to her on her godmother’s account. She offered to send a copy of the documents to the company. At the time, her godmother was just coming home from the hospital and was being cared for by an in-home caregiver. The goddaughter was not present but for infrequent visits, however, in love and trust, the power for delving into finances was given to her. Thankfully, the credit card company called the godmother who wisely told them no, she did not want her goddaughter to have a card. But A- the credit card company could have just accepted the goddaughter’s claim and B- the godmother might not have been well enough to have answered the call from the company and therefore accepted the goddaughter’s claim. 

  1. Checking accounts can and should have two people listed as account holders with the bank even if both names do not appear on the checks. It allows someone to pay another’s bills if that person becomes incapacitated. But remember, both people listed have authority to make withdrawls and transfers from the account. A person with a durable POA can do that too even if not listed on the account. When social security, pension, or other automatic deposits are made to an account all those who have access can get to that money.
There are plenty of cases where using/abusing adult family members prey upon the elderly.They move in or move near and ‘borrow’ often. Many offer to ‘help’ with such account setups then drain the family member dry. Others simply get the aged to turn over income checks to them in return for ‘services’ such as running errands. If you feel your aging loved one is being financially abused by another step in. Help him or her find a financial advisor, a counselor, or other outside party who can help determine the reality of the situation. This is where having a relationship with a banker who can offer advice and guide you is most helpful. It’s often that outside source who can help that person ‘see the light.’ It may mean that they learn how to tighten the reigns on accounts and access while setting up a per service amount for things that family member does for them, or they realize they need to restructure their finances to better serve their own long term financial security.

  1. Bankers can make notes (sometimes called flags) on accounts as to who may not have access to account information and money or when there is an issue of concern.
One caregiver knew a sibling with insecure finances was coming into town to visit their father while he was ill. She was concerned that her brother would try to access the parents’ bank accounts while there. Despite thinking all was set up properly, she took the extra precaution to alert the bank of the situation so that there was no question in her mind that the brother could not make a claim. 

In cases like family visits, it’s sad but true that sometimes financial documents like checks, bank account statements, and wallets (and purses)  need to be put away. Tell your loved one you have concerns and ask them to find a place they are secure with in ‘hiding’ their information. There should be a ‘safe’ person who knows where it is, but protection is key. It is difficult to bring these topics to the family table of discussion. In all likelihood, your loved one probably knows (or suspects) already and your support in finding solutions to potential problems will be a relief. Get it out in the open and deal with it before a family financial user becomes an abuser. 

The National Committee for the Prevention of Elder Abuse offers a great article about the financial abuse of the elderly. 

Thursday, July 7, 2011

An Uncomfortable Topic....Part 3

Where do you call for help?
As difficult as this topic is, we have to realize that elder abuse happens.  If we raise our own level of awareness and that of others, my hope is that we can help someone in need.
           As the bruising example in the last post, suspicions of physical and/or sexual abuse may be complicated by underlying condition. Yet if suddenly an elderly patient is receiving medication for a sexually transmitted disease never before diagnosed, alarm bells should ring. Caregivers such as children who live at a distance from a parent who is in a care facility can monitor things such as medication changes and follow up with doctors. Some of the easiest victims of abuse (any kind) are the ones whose family members seem out of sight. But living at a distance doesn’t mean you can’t be involved and monitoring the care situation. Another sign of physical or sexual abuse may be bloody clothing or bedding. If an elderly resident’s clothing and bedding are always washed by the care facility, it is difficult to discover. It is also difficult if an abuser is a family member and the victim lives in their own home. The emotions tied to family abusers over cause the victim to protect the abuser more than himself or herself. This is where surprise visits are useful to both the local and long-distance caregiver. If family members live out of town, find someone you trust to make occasional check-ins with your loved one. A long distance caregiver can even hire a care agency to do independent evaluations of their loved ones and report back to the family members.

For the elderly in care facilities, each state offers ombudsman programs can help residents resolve suspicions or problems with care facilities. An ombudsman is an advocate for residents (and family members) to help ensure quality and “reasonableness (see last post)” of care. AARP has a great article that offers more details about the use of an ombudsman for ensuring safety of the elderly.
Unfortunately physical abuse of the elderly can happen at the hands of family members. In one  instance, a drug-addicted adult child moved back ‘home’ using his elderly mother’s apartment as his crash pad. He had no problems pushing or shoving her around and kicking her out of her own bed. She didn’t feel safe. What were her options? Often the elderly feel they have none and suffer extensive abuse before it is discovered, if ever. But there are shelters across the country beginning to address the needs of the elderly in such circumstances. Abuse in the home is domestic violence - a criminal offense. The police can be called in to address domestic violence cases against the elderly. Unfortunately, the mental image that comes to most minds for domestic violence is not an 80 year old great grandmother or great grandfather and many do not report abuse fearing they will not be taken seriously.

Thankfully, the need for specialized services for elderly victims of such are beginning to be identified and resources are becoming available. AARP shines a light on the Weinberg Center for Elder Abuse Prevention located at the Hebrew Home at Riverdale in the Bronx, N.Y., the nation's first elder abuse shelter in a long-term care facility.             

As wonderful as it is, we have 49 states that do not have a Hebrew Home. Thankfully other such centers are being developed.  But how do you find them?            

If you suspect abuses such as the ones listed above or others, contact the Adult Protective Services agency in the victim’s community which is often connected with each state’s department of health and human services. 

  • The Eldercare Locator (800-677-1116) directs callers to senior information and referral telephone lines in their communities.
  • INFOLINK (800-FYI-CALL) directs callers to the closest, most appropriate services for victims of crime, including crisis intervention, assistance with the criminal justice process, counseling, and support groups.
  • The National Domestic Violence Hotline (800-799-SAFE [7233]) links callers to domestic violence shelters, other emergency shelters, legal advocacy and assistance programs, and social service programs.
Next Up:  Financial abuse and exploitation of the elderly.