Caring for an Aging Population by Alyson Kaplan

Posted on May 10, 2013 by Web-admin

May is Older Americans Month. When Older Americans Month was established in 1963 only 17 million Americans lived to 65 years of age.  In 2011, the first of the 78 million baby boomers (those born between 1946 and 1964) turned 65.  This kicked off a boom in the aging population that will continue for decades.  It is projected that the number of older Americans will reach 71 million by 2030 (when all baby boomers have reached 65 years of age) and 88.5 million by 2050.  The causes of death have also changed.  Death is now preceded by a slow decline from one or more chronic conditions such as Alzheimer’s disease, heart disease, diabetes mellitus, and respiratory disorders.  Caring for a family member is often challenging, impacting caregivers’ physical health, mental health, work, social relationships, and/or quality of life.

Sara (name changed), is a 58 year old woman who is caring for her aging mother, Helen (name changed).  Sara recently moved her mother, who has a diagnosis of Alzheimer’s Disease, from Florida to New Jersey.  Sara is married and has two adult children who no longer live at home.  She was looking forward to her husband’s recent retirement with plans to travel around the country.  Sara’s father was her mother’s primary caregiver until he passed away almost a year ago.  Sara was forced to confront her mother’s condition and has taken on the role of primary caregiver.  Sara described her mother as an independent and strong woman with whom she had a great relationship before her cognitive decline.  Now Helen displays signs of paranoia and is quite moody and agitated, often taking out her feelings on Sara.  Her caregiving has left Sara feeling quite frustrated, angry, and fatigued.  She feels guilty about not having patience with her mother.  Helen, in her mid 80s, believes her daughter forced her to move back from Florida and passes her days in front of the television in her apartment.  According to Sara, her mother is financially secure, however Helen believes that she is unable to afford help.

A friend convinced Sara to reach out to Jewish Family Service of MetroWest for support.  Sara enrolled in the free, telephone based Care Consultation program.  As a participant in the JFS Care Consultation, Sara is able to schedule appointments to speak on the phone as well as call on an as-needed basis.  Focusing on the unique needs of Sara and her family, Jewish Family Servcice of MetroWest have been able provide guidance, information, and support to empower Sara to find solutions to concerns about health and care, such as referrals for geriatricians, emergency response systems, home care agencies, and home repair and organization companies (to install grab bars and make other modifications) and awareness of community services for both Sara and Helen. We will continue to work with Sara as her caregiving role evolves and changes providing ongoing emotional and practical support.

The coming decades will not only see a significant increase in the aging population, but the growing need for family caregivers.  Caregiving is often rewarding, but undoubtedly draining.  Although these unpaid, family caregivers perform an important service, they often do so at a considerable cost to themselves.  It is estimated that families provide between 80 to 90 percent of the overall long term care to older Americans, including nursing care, personal care, household maintenance, transportation, and shopping.  According to the AARP, there are approximately 34 million Americans involved in providing care for a family member or friend 50 years of age or older.  The demands placed on caregiver and his or her support system (if there is one) changes and often becomes more demanding over time.  By enrolling in an evidence based intervention, such as JFS Care Consultation, caregivers can begin to regain some of the control lost during the often overwhelming caregiving journey.

Alyson Kaplan, MSW, LSW, is the Social Worker for Caregiver Services at Jewish Family Service of MetroWest.  The Jewish Family Service of MetroWest Care Consultation program is an evidence based support program established with a seed grant from the Healthcare Foundation of New Jersey.  JFS Care Consultation provides ongoing support and helps find practical solutions to meet ones needs, adjust to changes, or plan for the future.  For more information on Jewish Family Service of MetroWest and the Care Consultation program please call 973-765-9050 or visit www.jfsmetrowest.org.

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Addressing the Special Needs Housing Crisis

Posted on May 3, 2013 by Web-admin

With the end of April comes the end of Autism Awareness Month, a time where many have attended events to heighten the consciousness about those who have Autism.  I hope that our friends and families out there will continue throughout the rest of the year to support the efforts of research in Autism, the education of those with Autism, and the planning for adults with Autism.  As a professional in the world of working with families and their children with special needs, this is a 24/7, 365 day a year commitment for those families, siblings and other relatives.  Sadly, the needs of our children are not reduced.  As children with special needs grow into adulthood and turn 21 years of age, the concern of parents, siblings and other relatives becomes even more anxiety provoking.  The issue of housing and the stress of finding housing only increases, as New Jersey is very short on housing for adults with special needs.

Jerry (names changed), who was 34 with Autism, was the only son of Ted, who was suffering from a chronic condition that would end fatally.  Ted’s wife had already passed away 10 years ago and he was trying to sort things out for Jerry who would soon need to find a safe home. Fortunately, Ted had planned ahead financially to support his son and made the transition by putting in place a special needs trust, funding the trust, and transferring guardianship. For housing, Ted ultimately found Mt. Bethel Village, a safe and high level of community living with 24/7 supports specifically for adults with special needs and ASD (Autism Spectrum Disorder).  When Ted suddenly passed away, luckily plans were already made, and Jerry moved into Mount Bethel Village where he had friends on site, had his own apartment, activities 7 days a week, supervision for his medications, and a place to call home. Jerry continues to see his cousins, and his uncles and aunts, yet he is treated as an adult with his own apartment and independent living.

Jerry was one of the lucky ones whose family had the financial resources to provide such an option.  But for the many adults waiting out there for housing, such an option is not necessarily available.  We can support the Innovative Services Bill for adults with Disabilities S-2893, A-254, which appear to have support in the Assembly and the Senate for the Dept. of Human Services, to think outside box  by engaging both the private and public sector in coming up with alternatives in housing for our adults with special needs.  We need to address the housing crisis now.

Carolann Garafola is the Executive Director at Mt. Bethel Village located in Warren, NJ.  Mt. Bethel Village is an assisted living community that provides safety, comfort, and enjoyment of life to adults of all ages with autism, developmental disabilities, or traumatic brain injuries.

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The VA Backlog by Jon Stewart and the Daily Show

Posted on April 22, 2013 by Web-admin

We saw this informative Jon Stewart video and thought we’d share it with our readers.  When we file for Veterans Administration benefits for our clients we make certain that the VA receives a complete application – one which contains everything required to make a timely decision.  Regardless, most decisions by the VA take as long as ten months.  Jon Stewart’s video finally sheds some light (humorously) on the process.

http://www.businessinsider.com/jon-stewart-va-backlog-daily-show-video-2013-4

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The Rewards of Being at Home by Tamra Young

Posted on March 25, 2013 by Web-admin

Bill had been hospitalized in October 2010 after experiencing a severe fall.  He spent many days in acute care before going to a skilled nursing facility for several months.  Bill had lost all of the strength in his legs, was unable to stand, and required two aides to transfer him from his bed to the wheelchair. In addition, his appetite was poor and he had experienced significant weight loss.  He was extremely ill, was not expected to survive more than six months, and had started to receive hospice care.

I received a call from Bill’s family in March 2010 inquiring about our 24 hour home care services.  Although Bill was married, his wife, Betty, who was also 87 years old at that time, was not able to provide the care that Bill needed to be able to come home safely.   Betty as well as her daughter, Brenda, and son-in-law, John, wanted the best care possible for Bill and also wanted to respect his wishes to be home with Betty.  After serious consideration, they requested the services of Senior Helpers to supplement the hospice care that he was also receiving to enable him to return to his home.

With the dedicated care from Bill’s family, hospice, and our live-in caregiver, Marie, Bill’s health began to improve almost immediately after coming back home.  Brenda, a registered nurse and very loving daughter, was intricately involved in helping to oversee her father’s care.  She immediately put together an exercise program for her father to further his rehabilitation.  Marie, a Certified Home Health Aide, assisted Bill with his activities of daily living including bathing, dressing, and transferring.  She was also diligent about motivating Bill to make sure that he completed his exercise program a few times each day.

With the support of his family and Marie, as well as his own efforts and determination, Bill became stronger and his appetite improved within the first month of being home.  Within three months, Bill no longer needed assistance with transferring and was able to walk with his walker.  Within six months, Bill’s health had improved so significantly that he was no longer in need of hospice care.  The progress that he had made in such a short period of time was truly a miracle!

Three years later, Bill and Betty are still living in their home together.  Although Marie has left to be with her own family, another aide, Laura, provides care for Bill as well as Betty who now also needs assistance with personal care.  Laura has now been with Bill and Betty for about two years and is considered part of the family.  They are grateful that they have been able to stay in their home.  Last Christmas, they sent out their annual form letter to friends and family.  The letter said, “We are blessed we are healthy enough to stay at the house.  We have a live-in aide that is great help to our everyday needs, but we are still living here.  Sure, we gave up driving and we have body parts that ache, but it is nice to be home.”

Senior Helpers is a licensed Health Care Service firm.  We provide both companion as well as personal care services on an hourly and live-in basis.  We are dedicated to partnering with other organizations that are committed to assisting older adults and their families as well as giving back to the community.

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Honoring A Parent’s Wishes by Virginia Citrano

Posted on March 18, 2013 by Web-admin

Decades ago, my parents established living wills. They had gone to a seminar at my mom’s church and came away feeling that it was a good idea that my sisters and I knew exactly how they wanted to be cared for at the end of their lives. We listened to their plans, but thought it was creepy: Our parents were young, and in our minds they were going to stay young for a very long time.

Last year, my father’s declining health took a sharp turn for the worse. My mother, my sisters and I had to dig out his living will and commit to honoring it in earnest. We took him out of the hospital and, with the help of a hospice service, brought him home to be surrounded by some medical aid, like an oxygen tank, but more importantly his wall of family pictures and the sounds of Italian opera.

It was the hardest thing that any of us had ever done. On the nights when the pain medicines did not seem to be working, we doubted our abilities as caregivers. When people asked us when we were going to take him back to the hospital, it was sometimes difficult to explain that we were following his wish to die at home. It was painful to listen as friends shared the guilt they felt at not having dealt with a death in the way the dying person wanted them to, or not know what their wishes were. We had my father’s written guidance, and we followed it to the end. And my sisters and I discovered that we were grateful that our parents had so clearly expressed their wishes about death.

There are many subjects that don’t make for easy dinner-time conversations. Death is one of them. But having that conversation can make even a difficult death much easier.

Virginia Citrano is the editor of MyVeronaNJ.com, a community news Web site in Verona.

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Homecare That Makes a Difference by Rachel Cohen and Robin Goldberg

Posted on March 11, 2013 by Web-admin

Using a home care agency, from several times a week to 24 hours a day, helps older adults remain in their homes independently and safely. A companion increases the client’s safety and functioning while enhancing quality of life. Finding the right agency can also bring peace of mind to family caregivers whether they live near or far. Below is an example of how one woman’s quality of life has greatly improved with the care and compassion of an outstanding aide from JVS Caregiving Companions.

Several years ago, Mrs. Frank (not her real name), a resident of Essex County, was facing serious health challenges. She was in and out of the hospital over a period of several months and became very frail. When she was at home she was reluctant to walk from one room to another because she was afraid to fall. She became withdrawn and found doing almost anything, even chatting with friends, exhausting.  Mrs. Frank was not eating properly, her house needed to be tended to, and she only left home to go to doctors’ appointments.   Mrs. Frank was feeling weak and discouraged as her confidence and independence were deteriorating.

The client’s children, who live out of town, were very concerned and understood that Mrs. Frank needed extra support. They contacted JVS Caregiving Companions to schedule an aide for  several days a week to prepare meals, help with the housekeeping, go grocery shopping, supervise showers and make sure that the client’s overall needs were being met.  With the help of the caregiver, Mrs. Frank slowly regained her strength, confidence and independence.

In addition to her general duties, the caregiver started to take Mrs. Frank to the local community center to play mah jong and to Macy’s to shop.  Mrs. Frank’s children credit much of their mother’s improvement, both physically and emotionally, with the outstanding care that the JVS Caregiver has provided.  The client’s son and daughter-in-law have told office staff that “the Caregiver has made a difference in our mom’s life and has given her the will to live again; she cannot live without her.  The Caregiver has become a part of the family and treats her like her own mother.  They have become very good friends.”

JVS Caregiving Companions serves Essex, Morris and Union Counties.  Service is flexible, reliable and economical.  JVS Caregiving Companions provides hourly and live-in assistance in private homes, senior buildings, and skilled medical facilities.

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Achieving the Ultimate Level of Independence by Shari McCarten

Posted on February 22, 2013 by Web-admin

There are many different circumstances in which home care has impacted people’s lives.  Here are two people in completely different situations who have benefited from the resources that ResCare HomeCare has to offer.

The first person is Tony, who lives in Verona in a carriage house that is on his daughter’s property.  Tony is an 85-year-old man who had been in excellent health up until this past year.  Then, it was discovered that he had a subdural hematoma, on top of being recently diagnosed with Alzheimer’s.  Upon his discharge from the hospital he was told that he would need a live-in home health aide.  The family hired someone privately but soon realized that when the aide needed time off or if there was a problem, they had no backup.  When Tony’s health improved, he was able to discontinue the aide. Still, his daughter did not feel comfortable leaving him alone in his home.

Tony was referred to my home care agency and I provided his daughter with information on a monitor system that we offer called Rest Assured.   This system is individually tailored to each patient’s needs and Tony’s daughter felt that it was perfect for her dad.  Tony was able to stay in his home alone and still be monitored on a daily basis.  When Tony needed to be hospitalized again, the family wanted to hire a live-in home health aide.  We were able to put the monitor system on hold and get a live-in aide to be with Tony 24 hours a day, 7 days per week. When our aide needs time off, we make sure to get a replacement so Tony is never left alone.  Since Tony has both the monitor system and a home health aide, he is able to stay in his home safely.

The second situation involves a young man named Barry, who resides in Newark. He is a 16 year old with Cerebral Palsy.  He is contracted, nonverbal, and has a feeding tube.  His mother has medical issues so she is unable to care for him.  Through Medicaid, our agency provides 16 hours a day of nursing visits plus 23 hours a week of an hourly home health aide.  The aide takes care of all of Barry’s personal care, such as bathing, dressing, light housekeeping, and laundry.  The nurse makes sure that Barry’s medical needs are met and that he remains safe and comfortable in his home.  Since Barry receives all of this home care, he is able to stay home with his mom and does not need to be placed in a facility. He is also able to attend school and socialize with other children like himself.

ResCare HomeCare has assisted many different types of patients. We accept private pay, Medicaid, and long term care insurance.  We help keep people in their homes so that they can achieve their ultimate level of independence.

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Determining if Home Healthcare is Right for You by Julie Hattersley

Posted on February 15, 2013 by Web-admin

One of our clients, Gerry, recently came to us at Caring People with a big thank you for not only taking such good care of his wife and allowing him to focus on his own health issues and recovery, but also for making his home a happier one.

Gerry suffers from a form of cancer and has been receiving treatment leaving him lethargic and not able to do the things he once did to assist his wife, Addie. Addie recently suffered a stroke and has a brain tumor, which has affected her behavior. All Gerry wanted was to keep his wife happy and take good care of her; however his illness was no longer allowing him to be the husband he once was. This was very frustrating to him. Addie did not have an understanding of Gerry’s illness and she would become very upset that he was not himself. Gerry had the dilemma of considering nursing home placement for his wife, at least temporarily. Not having any involved family members to assist with his decision, the idea tore him apart as he did not want to be separated from Addie, and wanted to keep her at home.

After a visit to their physician, Gerry explained his frustrations and his doctor referred him to Caring People Home Healthcare Agency. Gerry had never heard of Home Healthcare and decided to explore the option.  Soon after he placed his call, a Homecare Consultant with an RN from Caring People visited their home and completed a home safety evaluation and assessed both Gerry and Addie to determine the appropriate plan of care. By the next day a certified home health aide (CHHA) arrived to their home to help. In a short period of time, as Gerry explains it, his wife has become a different person.

“My wife is smiling again,” says Gerry. “Marcella, our aide, is a compassionate angel who knows how to work with Addie and gives her companionship and security.” Now, Gerry is able to rest after his treatments and not have the stress of worrying about Addie while she is being well cared for. “Our home is a happier one since Marcella came into our lives and we thank our doctor for telling us about Caring People. This decision has allowed me to keep Addie at home where she belongs – with me.”

At Caring People Home Healthcare, our mission is to set and raise the standards for private duty home healthcare, through innovation, education, and service.  It is our goal to continually evolve to meet the needs of our clients and employees. We are family owned with offices in New Jersey, New York and Florida and have recently become CHAP (Community Health Accreditation Program) accredited. Our services include skilled and non-skilled care from CHHA, CNA, LPN and RN’s as well as companion services. Free in-home or in-facility consultations are conducted by one of our Homecare Consultants to educate families on services offered and determine a plan of care tailored to their specific needs.  Home healthcare is a great option which allows folks to remain at home for as long as possible.

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Avoid the Risks of an Untreated Hearing Loss by Marvin Kleinman

Posted on February 11, 2013 by Web-admin

One of our patients, Judy, came to us to have her hearing tested at the age of 89.  For years she had a hearing loss, even going so far as to try hearing aids one time five years ago. She never wore them consistently and told herself that hearing loss was “the price to pay for living a long life,” and that it was not “worth the trouble,” to do anything about it.  Slowly, over time, she withdrew from socializing with friends and kept to herself more.

It wasn’t until she was unable to understand the eulogy at her son’s funeral that Judy decided to do something about her hearing loss.  We have worked with her to help her become better able to handle her new hearing aids, and over time, she has begun to re-engage in social activities at the Assisted Living facility at which she lives.  She says that life has not been this busy for her in a long time, and that she wishes she had not waited so long to do something about her hearing loss.

Judy is not alone—according to research released last year by Johns Hopkins University, almost 27 million Americans age 50 or older have a hearing loss, yet only one in seven uses hearing aids.  According to the lead researcher, Dr. Frank Lin, this is largely due to the perception, both in the medical community and in the general public, that “hearing loss is an inconsequential part of the aging process and you can’t do anything about it.”

The consequences of leaving a hearing loss untreated can be severe, including everything from increased rates of depression to increased risk of falling and dementia.  Importantly, for those planning for retirement, untreated hearing loss can lead to lost income ranging from $1,700 per year for those with minor losses to over $10,000 per year for those with significant losses.  By following the American Speech and Hearing Association guidelines, and having your hearing screened at least once a decade until the age of fifty and every three years after, you are taking the first step towards taking the care you need to avoid the risks of an untreated hearing loss.

At Beltone Hearing Care and Audiology, we believe in a patient centered approach to hearing loss.  We are a family owned and run practice that has been serving Union, Essex, and MorrisCounties for over three decades, and we take the time to help our patients make the right decisions about their hearing healthcare needs.  We know that proper counseling is key to good long-term hearing health. Our practice provides free hearing evaluations, and all Beltone Hearing Instruments come with free lifetime aftercare at over 1,700 affiliated locations throughout the United States and Canada.

Marvin Kleinman, MS CCC/A, NJ Hearing Aid Dispensing Lic #451

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Putting a Plan into Place by Robert Egan

Posted on February 1, 2013 by Web-admin

When it comes to long-term care planning we are typically faced with three options.  To self-insure, privately insure, or access government assistance programs.  Most clients have no idea which option suits their situation the best.  Even answering the questions of where and when to start can be a daunting task.

A client of mine who is now approaching 90 had these same questions.  Her husband, who had been in control of their finances for their entire marriage, had passed away 3 years ago.  She was lost and did not know where her income would come from. Moreover, her children were fearful that she would lose everything to rising medical cost (which began to exceed her income), paying “handy-men” to help around the house, and the looming “what-if” of a long-term care event. Considering the only assets she had were the house and around $200k in investments, coupled with her unwavering desire to leave these assets to her children, the possibility for a self-insurance program to be implemented was eliminated.  Additionally, based on her age, a private long-term care policy would have cost her roughly $20,000 per year.  Needless to say this was not a viable option either, and we had to start thinking outside the box and use some creativity.

Unbeknownst to her, because her husband had been a veteran, she was entitled to a monthly benefit of around $1,100 per month if her medical expenses exceeded her income and her assets were below $40,000.  Since she had assets valued at significantly more than $40k, we needed to implement an estate plan that would allow her to qualify for this benefit while also preserving her wealth. We accomplished this by putting her house and roughly $160,000 of her investments into a trust.  By doing this, in the eyes of the veterans program, her net worth met the stated threshold requirement.  This allowed her to immediately start collecting additional income, while also preserving her wealth, thus meeting her objective of leaving the home to her two children.

Often times, due to the difficult nature of this topic, most clients do not want to address these issues until it is too late.  She was fortunate enough to seek the advice of professionals early enough so that we could assess her options and put a plan into place.

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