Doris was one of the most independent 87 year olds I have ever known.  While other seniors her age were confined to nursing homes, assisted living centers, or living restrictive  lives , Doris was living life to the fullest. When I met her in 2007, her husband had just died.   She had no children or close friends that lived in Washington State. She stood 4 ft. 9 in. and had a club foot which limited her physical capabilities but she was determined that physical limitations would not hold her back.  She was always ahead of her time graduating from medical school in 1960 at a time where most women were confined to roles of raising children and keeping house, or working service jobs until they married.  

Doris was a real trailblazer in every sense of the word. She lived at the end of  the Long Beach Peninsula, on 20 acres of forested land, in a mobile home overlooking the oyster beds and tidelands of Willipa bay. She was a native of sunny Florida and  had just retired to the Long Beach peninsula 10 years earlier. When her husband died she wanted to fulfill one of her dreams of living surrounded by nature, so she purchased this home with bear, elk, and raccoons as her visitors. 

Doris was a modern day pioneer, feisty, strong willed, and tough. After many urges from me to get a  personal alert help button and wear it daily she only agreed after falling in her garden . She had a hard  time getting up. One douse of a  rain shower and covered in mud she finally agreed to that “modern day contraption”.

I marveled at Doris. I asked her if she was ever afraid being out there alone, and being so isolated from medical care and ambulance service. I lived 2 hours away from her  and could not help much.  She just shrugged and told me that “when the good Lord wants me I will go, but until then I’m going to live life the way I want to live.” She had lived a good life and was ready to go at any time.  She inspired me.

Doris died two years later. She had called her housekeeper to drive her to the Astoria hospital and passed away that week.  I was on vacation and learned of her passing when I returned. I was heartbroken.

As a Geriatric Care Manager I took a new look at the service we provide our senior clients. It’s all about keeping independence as long as they can, and giving them a reason to live, so their quality of life is as good as it can be.  With a little strategy and a plan, I set Doris up in her home so there was someone to check on her and clean her house, a personal alert  system to summon help if needed, and a caregiver if she lived to be discharged from the hospital. She had the peace of mind to know a safety net had been set up to free her mind of daily worry. She died happy at age 89.

As we approach Independence Day think of how you too can help a family member maintain their independence. Call Elder Options to arrange for a free plan  that’s right for your senior family member .  Although I would not suggest seniors living so isolated a life as Doris, its important to honor their wishes so they have control and chart their own course for the last years or months of their lives. I salute you Doris and miss you every day. 

June 15th is National Elder Abuse Awareness Day. In recognition of this event Elder Options sponsored a free community workshop on Elder Abuse Prevention in May. Elder abuse or neglect often is a silent crime that can occur in any setting especially in private homes, away from public scrutiny. The World Health Organization survey of the US says only 4-6% of elder abuse is reported in the home setting, but can also occur in nursing homes and other settings.
 

When most people hear the word abuse they think of physical abuse. Most people don’t realize there are 6 forms of abuse: physical, emotional, sexual, financial exploitation, neglect, and abandonment. Telltale signs of bruising, pressure marks, broken bones, can indicate physical abuse and are the most obvious signs. Unexplained withdrawal from normal activities, depression, changes in financial situations, body sores and skin breakdown, poor hygiene, frequent arguments between the family members and the elderly person can indicate other types of abuse or neglect. 

 
Abuse occurs in every demographic and happens to young and old. Family members are often the abusers. In a down economy many seniors and families will try to cut corners and cost by hiring a family member to earn money, “friend of a friend” or a neighbor to help do simple chores, or errands. Hiring someone without screening, caregiver training and certification, puts the senior at risk. At Elder Options we require all caregivers to go through 28 hours of training including Abuse Prevention Training. 

 
Preventing elder abuse means doing these three things: 
1. Listen to seniors and their caregivers 
2. Ask the senior questions when you suspect elder abuse 
3. Educate others about how to recognize and report elder abuse 
 

If you suspect an elderly person is being abused or neglected please contact Adult Protective Services 360-577-4929 or 1-800-682-2406, or your 
local law enforcement if it is an emergency. If you live in Cowlitz County and have questions you can call Elder Options and we will direct you in the correct way to report abuse or neglect. We also have available online or in our office a Consumer Resource Guide to hiring help in the home. 

Are you interested in Disaster Planning? Our upcoming free workshop for the public is scheduled June 14, 5:30 PM – 7:30 PM. You will learn how to prepare safety kits for your family, have a family disaster plan, what to do if there is a natural disaster and more! Call 636-1000 to reserve your spot. 

Are we talking about your teenage daughter? No… does this sound like your elderly mother, grandmother, or dad? Maybe. You are concerned. What should you do? Now is the time of life to start the discussion for everyone’s peace of mind.

The aging process can be a long bumpy road; by planning, you can eliminate most “pot-holes”. Many decisions need to be made and discussed to maintain quality of life, and independence. This is the time of life where families need to pull together and listen to what the senior’s wishes are. Some topics might not be comfortable to talk about but it is necessary in the event there is a sudden illness, injury or surgery. Decisions must be made before life’s crisis’ occur, to reduce stress for all, and to enhance peace of mind.

As a Geriatric Care Manager, I suggest to seniors and families to try the least expensive, least disruptive option first, (unless their health is in jeopardy or they need 24 hour care after surgery or major illness.) So for instance: if you are 78 years old and your body and life have begun to slow down, the next step is not necessarily an assisted living center that could cost about $4000 a month. A small step might be, getting a housekeeper once a week, and a personal alert system in the home that might cost a total of $175 a month for both services. The next step could be transportation service as needed, or a companion to help with errands such as grocery shopping. When you call Elder Options the advice and consultation you receive from our Geriatric Care Manager is always free.

Elder Options is the only Geriatric Care Management agency in southwest Washington. If your family is spread around the country and the senior worries who will be there if they need help, a geriatric care manager can set up a care plan designed by the senior. Does the senior want to live at home or downsize and move to an apartment or senior community? Do they qualify for any government-funded programs, veteran’s benefits, or have long term care insurance?

A care manager is like having a life coach who specializes in senior issues. If you have question on senior services, you can call our new free pre-recorded senior information line 360-524-7411. To speak to a Care Manager call 360-636-1000.

For more information on how Geriatric Care Managers can help seniors cut through red tape and save money log onto www.elderoptions.org and click on “How We Are Different”. If you have questions or comments please email info@elderoptions.org

Published in The Valley Bugler April, 2011 http://valleybugler.com

What makes a good senior caregiver, and why would you want to work with-in the profession?

Reasons to Work in Senior Care

Senior care is a calling. It requires a level of dedication and compassion that is required in the healthcare industry. Every professional working in senior care has a story, a reason behind their decisions to help others.

Personal Experience

Many senior care professionals began in the “Sandwich Generation”, caught between the needs of their own family and that of their elderly parents or grandparents. Having experienced the challenges and rewards firsthand, they felt drawn to continue providing care for others.

Some individuals may not have been responsible for directly providing care, but have witnessed their family’s struggle to find/provide quality care for a loved one. They choose to work in senior care in hopes of making the road easier for others in the same situation.

Making A Difference

Most people want to make a difference in this world. Helping seniors remain independent at home or more comfortable in their retirement community is a great way to accomplish this.

Jobs in senior care offer an opportunity to serve with high personal reward. These individuals have a true desire to improve the lives of elderly and raise the standards of care they receive.

Stability And Growth

There is currently a high demand for healthcare professionals in general, but the outlook is for greater need in geriatric care. This makes a career in senior care even more attractive for job seekers at all levels.

It’s no secret that today’s aging boomer population will need more care over the next 20-30 years. This translates into not only job stability, but more opportunities for advancement in the future.

Senior care is a great choice for many because it offers such diverse options for work settings and varied schedules: Assisted Living, home care agencies, nursing homes, hospice, all need compassionate staff.

Relationships

Professionals in senior care often prefer the close one-on-one relationships they develop with their clients. They are more connected in a long-term care setting and enjoy hearing about the older generation’s memories and experiences.

Flexibility

Caregiver careers are perfect for college students needing weekend or evening hours to help fund schooling, or retirees who would like to supplement their income without committing to a full time job. No matter what your age, caregiving jobs provide flexibility; you choose the schedule that fits your life.

Uniquely Rewarding

Senior care professionals enjoy a personal sense of fulfillment from helping others each day. They often earn the gratitude of families whose elderly loved ones need care they are unable to provide themselves. Even when families do not recognize it, there is unquestionably a special satisfaction that comes from providing comfort for those in the final stages of life.

Published in The Valley Bugler March, 2011 http://valleybugler.com

When you think of a caregiver, do you think of a nursing assistant overworked in a nursing home? There are many different types of work settings and many are stepping-stones to the nursing professions, which could pay $20-$35 a hour or more.

In-home care is often the easiest and most fun of the work settings. A caregiver can work with one or two persons in a private home, they can cook, run errands, take a senior or disabled person shopping, drive them to activities like the YMCA, or other community events. Simply walking the lake or a craft project helps the senior keep an active mind, body, and spirit. Some seniors need just a couple hours a day of assistance or once or twice a week. Its perfect for the 55+ age group that don’t want to get tied down to a confining job, rather they are looking for a rewarding activity.

There is a need for: 4, 8, 12, and 24-hour shifts in the home for medically fragile clients. These clients may have Alzheimer’s, cancer, or those discharged from the hospital. These jobs can be more challenging in terms of knowledge and training needed.

In the Eldercare Industry, a person can work one or more jobs to earn more than the standard 40-hour week limit, when they mix and match employers. Elder Options keeps a list of employers looking for caregivers and CNAs.

For people who want faster paced activities, working in an assisted living center or adult family home is the place to apply. A caregiver or nursing assistant will care for 20 – 30 residents, which gives a variety of personalities and situations to make the job interesting.

If you want to step up the career ladder, a Certified Nursing Assistant (CNA) is the next step. CANs need to go through 85-100 hours of training and can work in most settings. Nursing homes, doctors offices, hospitals and the previously mentioned in-home care jobs all need compassionate CNAs.

These two-job classifications are the perfect stepping stone into any medical profession. It is important to learn if you like working in health care before you invest in college tuition to learn nursing, or various therapies.

Elder Options has provided caregiving training and job placement services for the past 15 years in Cowlitz and Clark Counties. Call us at 360-636-1000 or log onto www.elderoptions.org/caregiver-corner/ for more information.

Published in The Valley Bugler February 2011 http://valleybugler.com

Winter Blues:

Approximately 2000 seniors in Cowlitz County have been notified that the Medicare plan they currently have will not be offered in Cowlitz County as of January 2011. Insurance is a very confusing topic for seniors who are shopping for supplemental medical insurance, long-term care and Medicare Plus insurance policies. So for this months article I would like to introduce Andrea Zielger Elder Options Insurance Specialist.

In my role as the Insurance Specialist at Elder Options I am surprised with how many people who call me are shocked to hear their Medicare or Retiree Health Insurance typically does not cover caregiver services in the home. For people who prefer to stay in their homes, it is wise to have long-term care insurance. This insurance will typically cover activities of daily living (dressing, meal preparation, medication assistance, etc.) while medical insurance companies cover acute or skilled care, provided by physicians, RNs, and therapists. Services of a caregiver in the home to assist with the activities of daily living are considered to be “custodial care” and does not meet the insurance companies medical necessity requirements. The definitions of medical necessity and custodial care may vary but I can define them as the following:

Medical Necessity: Services or supplies which meet the following tests:

* They are appropriate and necessary for the symptoms, diagnosis or treatment of the medical condition.

* They are provided for the diagnosis or direct care and treatment of the medical condition.

* They meet the standards of good medical practice within the medical community in the service area.

* They are not primarily for the convenience of the plan member or a plan provider.

* They are the most appropriate level of supply of service which can safely be provided.

Custodial Care: Custodial care is; that care which is primarily for the purpose of assisting the individual in the activities of daily living or in meeting personal rather than medical needs, which is not specific therapy for an illness or injury and is not skilled care.

Elder Options provides information on long-term care insurance in our resource center. I recommend persons who know they want to stay home and would like some coverage to look into Long Term Care Insurance early. Make sure you get a good agent, one you can trust. I have seen policies purchased with elimination periods anywhere from 30-100 days. An elimination period is the amount of time you must pay privately for care before the policy begins to pay. A lower elimination period may increase your premium a little but, more often than not it is worth the coverage you will receive when you need to utilize the policy.

The more informed you are the better choices you can make. Insurance lingo is often times confusing. Here at Elder Options we will guide clients and assist in researching and filling out claim forms to utilize their policies. I have assisted members of the community with coordinating their claims with secondary insurance, reviewing renewals, and explaining Insurance explanation of benefits letters. If you feel you need some level of assistance I would be more than happy to help, please give me a call.

Published in The Valley Bugler December 2011 http://valleybugler.com

Consumer Beware- Hiring Home Helpers

According to a recent MetLife Mature Market Institute report, elders lose at least $2.6 billion a year to financial abuse. Many are taken advantage of by  “friends”, neighbors, acquaintances and sometimes family members.  “Rip-offs” can happen to people of all ages, but are more predominate in the senior age group. As we age we grow more vulnerable, and decision making skills are sometimes compromised. Cowlitz and Clark County have formed the Vulnerable Adult task Force so law enforcement, county officials, medical and social services can help identify financial, emotional or physical abuse.

It is important to know the guidelines required for people who work with the elderly in a caregiving role. With the recession going into its third year, I have noticed some people hiring unemployed family members, or acquaintances who have no training.  “Under the table” workers can either intentionally or innocently make mistakes in judgment that can cause harm to a senior or disabled person of any age.

There are many things that can go wrong when hiring un-trained people. It is not uncommon for unscreened persons to borrow or steal items from seniors and then sell them. Forging checks, borrowing money, befriending seniors and then getting written on their wills, seniors hiring people who have been fired due to drugs/alcohol or misconduct are issues to be concerned about. Some unscrupulous people charge double of what home repairs or household chores would cost, and the senior pays not knowing what the going rates are.

The minimum requirements for hiring caregivers in Washington State are: Caregivers who work in homes should go through a criminal background check and as of January 1, the State will require fingerprinting.  They need to be in good health, and free from communicable diseases or conditions.  (Hepatitis, HIV, lice, etc.)  They should attend the Fundamentals of Caregiving class, a 28 hour class which covers: state laws on elder care, infection control, medication management, legal liabilities, back safety and transfer techniques, activities of daily living, special diets, dementia, and more.

The training requirement expands from 28 hours to 75 hours as of January 1, 2011. Caregivers will need to be registered with the state so employees can track problematic behaviors. Their license can be pulled in case of abuse, exploitation or neglect in the home. When you hire from an agency you want the assurance of bonding and liability insurance, and someone to oversee the actions of the caregiver in the home. If a senior finds they do not like the caregiver or the caregiver invites personal friends into the home, an agency can correct poor performance or terminate the caregiver.

As state laws grow more complex, I suggest people contact our office to help them through the process. As part of our community service effort the information is free.

When hiring housekeepers the same concerns apply. It is very important to get bonded housekeepers and go through an agency. You need protection in case of damage, loss, or theft of your possessions. If helpers hurt themselves in your home you can be liable unless you hire through an agency

Elder Options provides Caregiver Certification classes for both family and paid caregivers. Anyone interested in training should contact us before the higher tuition rates begin January 1. Log onto our website www.elderoptions.org and visit “Caregiver Corner” for more information.