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children help with caring for seniorsMost people have fond memories of at least one of their grandparents. These are some of our most cherished relationships. It’s important to both your children and your parents that they make the most of this relationship while they still can. During this difficult time when the family struggles with dementia or the poor health of your parent, strong grandparent-grandchild relationships are vital and can be very nurturing to them both. Often people leave children out during times of illness, but if this happens they can miss out on the chance to help a relative who needs them. As adults, we want to feel that we are valuable and that we’re making a contribution to our world. That’s what makes old age so tough – we can begin to feel that we’re no longer relevant and that we no longer matter. Kids, on the other hand, want to be recognized for what they do well, especially when they’re teenagers. Kids today often don’t know much about history, and this is where a good relationship with their grandparents can really benefit them. They have much to learn about where they come from, and about things that happened before they were born. Even if your parent thinks your family history is unremarkable, your kids are likely to be curious and glad to know where they came from. And kids, in turn, know quite a few things that grandparents don’t. They may be able to set up your mom’s new DVD player faster than you can say “Gone with the Wind” or they are pros at doing that cool new dance everyone’s talking about. Even a sullen teenager may be more receptive to assisted living visits if you find some way to incorporate their talents. Maybe they can build an online photo album with treasured images to share with their grandparent. Or, if they were just in a school play, maybe your child and their classmates will agree to volunteer to perform a few scenes to entertain the assisted living residents. (Won’t mom be proud!) Make sure that both grandchild and grandparent know what they can contribute to the other, and ask each of them privately to help you by contributing their knowledge and spending time together. By each of them sharing what they know and what they’re good at, grandparents and grandchildren can meet each other’s emotional needs. So getting them to spend time together can be good for your parent, good for your kids, and ultimately, good for you because everyone’s happier and a little less stressed.
using life insurance to pay for assisted livingWhen thinking about how to pay for assisted living, one option that seniors and their caregivers forget about is the ability to turn any active life insurance policy into a long-term care benefit plan. This little-known option has actually been in existence for decades, but few people take advantage of it. Once a person reaches old age, life insurance is nice to have but not crucial, as more often than not they don’t have any dependents. However, long-term care is a major expense at this point in time. This option gives seniors the flexibility to use this investment for needs that are more pressing. The benefit can be used with any type of life insurance policy: term, whole, or universal. In some ways, this benefit is similar to regular long-term care insurance (though the two are not exactly the same).  Once the life insurance policy is converted, ownership of the policy shifts from the policyholder to a benefits administrator entity. The benefits administrator takes over responsibility for paying the monthly premiums on the policy. An account is set up from which the benefits administrator pays a specific amount, based on the value of the policy, towards the original policyholder’s long-term care needs. Often the monthly payment is flexible – for example, if the value of your policy is $24,000, you might be able to choose to receive $2,000 per month for 12 months, or $1,000 per month for 24 months. It may not be a large enough amount to pay the full assisted living bill, but it can yield a significant monthly sum that will go a long way towards defraying costs. In many cases, the long-term care benefit is worth much more than the cash the policyholder would get by simply surrendering the policy. Taking this option doesn’t mean completely forgoing the benefits of life insurance. You are often able to keep a small funeral benefit worth around one or two thousand dollars. There are several reasons why this route may NOT work for you. For example, if you have a small policy of $10,000 or less, you’ll likely find that it’s better to choose the cash surrender value or simply keep the life insurance. Also, in some cases the cash surrender value may be larger than the long-term care benefit. Finally, in order to use this option you must have an immediate need for some form of approved long-term care. Payments are made directly to the long-term care provider, not to you. If this seems like a possible option for you or your loved one, speak with a financial advisor who specializes in helping seniors.
selling home when your parent has Alzheimer'sWhen it comes time for a senior to move into assisted living, one of the most important items on the to-do list is to sell the person’s home. Often, the money from the sale is needed to pay for necessary care. It has to be done, but there’s a catch: only a homeowner can legally sell their home. If Alzheimer’s has already incapacitated the person, then getting this task done becomes difficult. Basically, you cannot act if you do not have power of attorney. Hopefully, your parent was organized enough to assign this power to a family member or other trusted person while they still had the capability to make these important decisions. But all too often, this step has been postponed, and now that the parent has lost capacity to make decisions, it’s too late. The caregiver’s only option now is to apply for guardianship of their loved one through the legal system. However, be forewarned that the process of obtaining guardianship is expensive and draining. For one thing, the court will need to award you the right to complete every step of the process. You need to have permission to sell the home, you need to get court approval of the sale price, and then you need to have permission to use the proceeds to pay for senior care. Getting these rulings made will take anywhere from a few weeks to a couple months, which seems to be a long time to wait when the money is needed now. The first step is to find a buyer who’s interested in the house, and then get them to sign a contract. The contract must state that the sale is conditional upon court approval. You can then file this document with the court and wait for them to review it and approve the terms of the sale. Unfortunately, it’s not uncommon for buyers to decide that this extra step is too much trouble. If they can find a house they like just as much without restrictions like this, they may decide to walk away from the deal. The process isn’t necessarily any easier even if the caregiver has power of attorney. Sometimes the title company puts up obstacles and challenges the validity of the agreement between the senior and the caregiver. They may want your parent to still sign something to approve the sale, or they may want to meet with them to confirm that they are incapacitated. In the end, the takeaway message is that selling a parent’s home is complicated, and you should be prepared for a lengthy and challenging process. Your best course of action is to find a lawyer specializing in elder law, who will be able to guide you through the process in the most painless way possible.
how to talk to someone who is dyingWhen someone has received a terminal diagnosis, it’s a sensitive and traumatic time for them. Our words and actions at this point carry great weight. While it would be nice to believe that there’s no wrong thing to say and it’s the thought that counts, those close to the dying can make the experience easier or harder for them depending on what they say. If your loved one has recently received the bad news, look to them for clues about what to say and do. Don’t be surprised if they in fact don’t want to talk at all. People facing their own passing are often relieved to not have others say anything – though they are also glad to know that they can reach out if they choose to do so. Do your best to respect what they want, but find ways to make it clear that you’re willing to offer a listening ear when they need it. Rather than fretting about what to say and whether it’s the “right thing,” put your energy into listening to and observing your loved one. Whatever you do, avoid grand platitudes about fate or God’s will. These won’t make the person feel better, and may even make them feel that they are at fault for their illness in some way. Don’t tell your loved one that they’ll be OK – both you and they know that this isn’t really true. Don’t try to praise them by telling them how strong they are – at this time they may not feel very strong. Instead, they need to be allowed to acknowledge their fears. Find ways to emphasize that you love them and that you’re there to help them in the way they need. Do your best to make this time pleasant and comfortable for them. This is one exception to the advice to let your loved one guide you – as far as comfort goes you should take the lead. This is the time for random acts of kindness like making them breakfast or doing their laundry for them. They may be too preoccupied to ask for help with these everyday tasks. Make sure that you follow through on any offers you make. What gift do you give someone who doesn’t have many days left in the physical world? The gift of your time. Even sitting quietly with your loved one can be valuable to them. It sends the message that you’re there for them and that you’re willing to support them in their struggles.
guide to online pharmaciesMany of us are doing more and more online shopping, and so inevitably we wonder if we should buy medication online too. Beyond the simple convenience, the cost savings are certainly tempting, especially when dealing with an expensive chronic condition. However, the world of online prescription drugs is one that needs to be navigated with caution. Counterfeit medicine is abundant, and the old saying that “if it seems too good to be true, it probably is” was never more apt. There are both legitimate and illegitimate online pharmacies, and the trick to buying medicine online successfully is to be able to tell the difference. By taking the time to gain a little knowledge, you too can be an informed consumer and avoid getting burned. Here are signs of a reputable and safe online pharmacy:
  • They require that you submit a prescription from your doctor. Usually they will ask for this by mail. If they allow you to send a fax or a scanned copy, they should then check with your doctor to make sure that the prescription is legitimate. Avoid sites that will send you medicine just on the basis of a questionnaire, without requiring you to visit your doctor.
  • They should also require that you fill out a detailed profile that includes your medical history.
  • You should be able to speak to a licensed pharmacist who can answer any questions you might have.
  • The pharmacy should be located in the United States. Many online pharmcies are located abroad. The prices may be cheap, but as much as 40% of the medicine in these countries is counterfeit, so you’re much more likely to not get what you paid for, or even something that’s safe to consume.
  • You can easily find and understand the website’s various policies regarding privacy, shipping, and payment.
Officials recommend that you only use sites that have accreditation from an organization called Verified Internet Pharmacy Practice Sites (VIPPS). This insures that the company has gone through a rigorous review process and on-site inspection. You can find a list of pharmacies that have achieved this accreditation at the National Association of Boards of Pharmacy. When your order arrives, make sure that all the information on the label is correct, including your name and the name of the medication. Make sure that the dosage you’ve been given matches what the doctor ordered. Also keep an eye out for packaging that seems to be tampered with. If this is a medication you’ve taken before, compare its color, shape, and size with what you’ve taken previously. Do you see, taste, or smell any differences? You should also be able to easily verify that the medicine has not expired. If you have any doubt about what you’ve received, don’t take the medication until you’ve spoken with your doctor or pharmacist. This may be a hassle that negates the convenience of online shopping, but it’s much easier than making a mistake that could be costly or lead to further health problems.
should you see geriatric specialistYour loved one has multiple doctors already. Do they really need to add one more to the list? This post is designed to help you decide whether your loved one should consider seeing a geriatric specialist. A geriatric specialist provides comprehensive care for the elderly. They’ve completed their residency in Family or Internal Medicine, and have one or two years additional training in the various issues – physical, mental, and social – that affect this age group. There are several benefits to seeing a geriatric specialist. Seniors sometimes experience illnesses differently than younger adults, and so it helps for them to work with a doctor who understands their specific situation. Geriatric specialists are especially well-equipped to understand the particular complexity of senior health issues, which are typically caused by multiple factors. For example, they can examine a senior’s prescription drug regimine and make sure that they’re not over-medicated. They will also be familiar with the particular resources available to help your loved one in your specific local area. Whether or not a senior should see a geriatric specialist depends on their particular situation. After all, seniors themselves are different: one 80 year-old may be active with minimal health problems, while another may be struggling with serious health conditions. Geriatric specialists tend to step in when an individual’s health problems become complicated. It’s recommended that all seniors consider a visit when they turn 65, and highly recommended for those seniors who are in some way impaired, who have multiple medical problems, who are experiencing cognitive decline or dementia, or whose family members are struggling with caregiving. If you do decide to take your loved one to see a geriatric specialist, the initial assessment will take several hours. You’ll be given a detailed questionairre to fill out that your loved one will most likely need help with. Make sure you bring a list of all medications, hearing aids and dentures, eyeglass prescriptions, and information about other doctors your loved on is seeing or has seen recently. The following elements make up a typical assessment:
  • Complete physical exam
  • Detailed medical history
  • List of medications and their purpose
  • Dental exam
  • Hearing and vision tests
  • Pain level analysis
  • Cognitive evaluation
  • Osteoporosis screening
  • Dietary analysis and advice
  • Meeting with a social worker
  • Discussion with family members
Rather than being “just another doctor” a geriatric specialist can help you with managing the extensive medical care your loved one is already receiving. Many seniors and their caregivers find these physician’s particular expertise helpful.
is dementia hereditaryIf you’re diagnosed with a disease, often one of your biggest worries is whether or not it’s hereditary. Will you pass it on to your children and grandchildren? Or those who are watching their parents struggle with a disease wonder, “Will this be me one day?” Dementia is no exception. The good news is that in most cases, dementia is not a hereditary disease. However, this does vary depending on the type of dementia, and it may be that the inherited nature of dementia is too convoluted for researchers to fully understand it yet.  Genetics is complicated, after all. We can see this with more basic traits: even if both parents have brown eyes, their child’s eyes might turn out to be blue. Or a trait like height may be influenced by several different genes. Alzheimer’s disease is usually not inherited, though if someone in your family has had the disease there’s a slightly greater chance that you’ll have it too. Early onset Alzheimer’s is one specific form that does tend to occur within families – though this version of the disease is more rare. Huntington’s disease, on the other hand, is clearly hereditary, and it’s a little known fact that this is a form of dementia. Other types of dementia that run in families include fronto-temporal dementias: as many as 50% of those cases seem to be hereditary. While genetics has its influence, our environment and our lifestyle have perhaps an equally powerful role. Since families share similar ways of living, it can be difficult to sort out what happens due to genetics and what happens due to environment. If you’re worried about you or someone you love developing dementia, rather than look at family history you may find more connections by considering the following:
  • Women are more likely to develop Alzheimer’s disease than men are.
  • Researchers have determined that diseases of the heart, blood, or arteries are linked with an increased chance of dementia. This includes heart attacks, high blood pressure and cholesterol levels, and especially strokes.
  • Those who have a history of depression are more likely to develop dementia.
  • Repeated or severe head injuries are also a risk factor.
If you have concerns that you or a loved one will inherit a form of dementia, talk to your doctor. They can provide guidance about how likely it is that your form of dementia is inherited, and can give you guidance about whether a step like genetic testing and counseling might be worth it.
caregiving for in-lawsYou expect to have to care for your own parents in their old age, but often times we find ourselves caring for our in-laws too. For many this isn’t a problem, as they’re your spouse’s parents and part of your family. But sometimes, this situation presents issues when we have conflicts with our in-laws. It’s also not unheard of for someone to be caring for their former spouse’s parents, even when they’re no longer married to that person. Then things become a little more complicated. Though gender roles are changing in contemporary life, it’s often women who find themselves in this situation. Sometimes their partner is helpful and supportive, but too often this isn’t the case. Men aren’t used to taking on nurturing roles like this and tending to someone physically. They may manage their parents’ finances or help with more manly tasks like mowing the lawn if his parents still live in their own home. And of course he calls the shots for the big decisions. But the women in his life end up taking on the responsibility for tasks like preparing meals and bathing – and this role is not always welcome on the part of the woman. If you find yourself in this situation, try appealing to your spouse’s desire to be a good caretaker. Once their parents have passed away, many children regret not doing more for them while they were still alive. Remind him that he’ll want to be proud of what he’s done for them. You’ll also want to remind him that doing so-called “feminine” tasks doesn’t make him less of a man – he’s getting hung up on stereotypes. If you work, you can also make it clear that you have just as much of a right to spend time on your career as he does. You have your other obligations too. In the end, you need to decide how much care you’re willing to take on, and then leave it to your spouse to handle things from there. Set strong, clear boundaries: ultimately his parents are his responsibility. Of course, if you’re married, you’ll need to take the health of your relationship into account with any decision you make. However, if you’re divorced, you have no obligation, though some women feel they should care for their former in-laws because they are, after all, their children’s grandparents. But the key point to remember is that you are in charge of your contribution.
mythsThere are many misconceptions out there about Alzheimer’s. Below are some of the most common, along with explanations about what the real deal is. There are cures that will stop the development of Alzheimer’s. Unfortunately, at this time there is no cure for Alzheimer’s disease, and no way to halt its progress. However, there are drugs that will, temporarily, pause the deterioration of or even improve cognitive skills and memory. But they only, for a period of time, treat the symptoms and not the disease itself. These drugs only work for some people, so there’s no guarantee that they can help your loved one. These drugs include cholinesterase inhibtors like Aricept and Exelon, and memantine (also known as Namenda). Cholinesterase inhibitors are used in the earlier stages of Alzheimer’s, and memantine is prescribed later on. The aspartame in artificial sweeteners contributes to memory loss. Aspartame is an artificial sweetener approved by the FDA in 1996. It is made by combining two proteins, phenylalanine and aspartic acid, with methanol, a chemical found in various plant foods. The studies that have been done on this issue so far have yielded no evidence of a connection between memory loss and aspartame. The use of aluminum in cooking or with food can cause Alzheimer’s. Current studies do not show that eliminating aluminum, such as that in pots and pans and soda cans, reduces one’s chances of getting Alzheimer’s disease. The jury is still out on aluminum’s relationship to the disease, but scientists generally think that it is unlikely that it has any significant effect. Alzheimer’s disease can be caused by a head injury. This one is partially true: researchers have proven that having a severe head injury with loss of consciousness during one’s life will increase the chances that the individual will get Alzheimer’s disease. However, researchers don’t yet understand why this occurs and what is happening in the brain during these incidents that leads to Alzheimer’s. Alzheimer’s disease won’t kill you. Alzheimer’s is, in fact, a fatal disease. It first destroys brain cells that assist with memory functions, but over time the damage will spread to parts of the brain that control essential bodily functions. It can be hard to attribute death to Alzheimer’s disease, however. Many Alzheimer’s patients, due to their age, are experiencing a number of health issues. It is likely that several different problems contribute to the actual cause of death.
senior day trip to the zooWe think of zoos as a classic class trip for children–but seniors can enjoy them too! Taking your loved one to visit a zoo, possibly with the extended family in tow, can be a great way to create togetherness and provide a stimulating activity for your loved one. In southern California we have some of the best zoos and aquariums in the nation, so this can make a great local day trip. Interaction with animals is beneficial both for seniors and their stressed caregivers. Research has shown that this activity contributes to lower blood pressure and makes people feel happier. The increased chance of social interaction that happens during a zoo visit, whether the senior is part of a group or just visiting with one caregiver, also has positive effects such as reducing the chance of depression. Your loved one will even get more exercise than they do when they stay at home. For various reasons, seniors are often not able to have pets. This can be a difficult restriction to live with for those who are lifelong animal lovers. But regular zoo visits allow these seniors to experience the benefits of animal interaction. Those who have Alzheimer’s disease or other forms of dementia can specifically benefit from zoo visits, as this environment can trigger happy childhood memories. Be sure to plan your trip carefully, as that will help the day go smoothly and minimize stress for both of you. Schedule your trip for a day when the weather will be good. You’ll want to arrive close to opening time, when the zoo will be less crowded. Discuss with your loved one what exhibits they want to see, and get a map of the zoo beforehand so that you can plan the best route for seeing everything on your list. That way you won’t get lost or waste time backtracking once you’re there. When you’re at the zoo, don’t be afraid to ask for help. The staff regularly deal with various people with disabilities and know ways to help your loved one get the most out of their visit. Zoos often offer priority seating during events for those with mobility or vision issues. Special audio assistance devices can also be arranged. And be aware that many zoos offer senior discounts or other special deals for the elderly. A trip to the zoo can be a fun diversion for both seniors and caregivers, breaking up the monotony of the day-to-day.