Littman Krooks

Have you considered having an elderly parent move in with you? Many people face this decision because of financial circumstances or because their parents need assistance with daily activities. Living with an aging parent can provide an opportunity to reconnect in a positive way but it also demands life style changes. Proper planning can make the difference in ensuring that this transition is smooth.

• Communication is key. When adult children of elderly parents think about how they intent to care for them, it is important to broach the subject with their parents early on to gauge their feelings. There are situations in which older people in which older people do not want to face the fact that they need help and may be resistant to leaving their home or accepting the care they need. However, even in these cases, any accommodations that can be made to the parents’ own preferences will make the transition easier for everyone.

• Advance planning is crucial, especially regarding financial matters. Remodeling may be necessary to make one’s home senior-friendly. For instance, if changes need to be made to permit wheelchair access or to add or remodel a bedroom or bathroom, then these costs need to be planned for. If part of the plan is to rely on proceeds from the sale of the parents’ home, then this too requires arrangements to be made well advance.

• What types of care are covered? It is important to consider what care one’s parents may need as they grow older, and how to pay for it. When making the decision to have an elderly parent move in to one’s own home rather than an assisted living facility or nursing facility, one needs to consider whether an in-home caregiver will need to be hired. If so, that cost needs to be included as one considers the financial planning aspect of the move. Is there a long-term care insurance policy? What Medicare or Medicaid coverage is in place? Take the time to learn what type of care may or may not be covered. Do not assume that providing care oneself is the least expensive option. Time taken away from work and incidental care-giving costs can add up and needs to be planned for.

• Communicate with Siblings. It is important to communicate with siblings regarding the cost of care. If an elderly parent is moving in with one sibling, then there should be clear communication with the other siblings about how they intent to contribute to their parents’ care.

Caregiving has financial and emotional costs that may not be recognized by others if they are not expressed. In addition to getting help from one’s siblings, if possible, adults caring for elderly parents should take full advantage of any services that are available to seniors and their caregivers in the area.

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A small pilot study indicates that equine therapy – spending time grooming, feeding and walking with horses – eases symptoms of Alzheimer’s dementia, making patients calmer and happier.

Equine therapy is used today for children and teenagers with emotional and developmental disorders, and the new study indicates that it may also be useful for older adults with Alzheimer’s disease.

Researchers at Ohio State University studied 16 people with Alzheimer’s disease who participated in activities at an adult senior daycare center. Eight of the seniors who volunteered for the study were taken to an equine education center while the other eight pursued other activities at the center. The clients visited the farm once a week for four consecutive weeks, grooming, walking and feeding the horses under the supervision of caregivers.

The researchers found that the patients who interacted with horses showed an immediate positive mood change and were less likely to resist care or become agitated later in the day.

Americans approaching retirement age are usually aware of the basic facts about Medicare. However, people sometimes make assumptions that can lead to pitfalls. It is important to know what to do and when, because mistakes can cause penalties.

One mistake some people make is assuming that they will not qualify for Medicare because they have not worked long enough. The waiver of premiums for Part A (hospital insurance) is based on the payment of Medicare taxes by applicants or their spouses for at least 10 years. However, for those who do not qualify for a waiver of Part A premiums, they still have the option to enroll in Part A and pay premiums.  Additionally, one does not need work credits to be eligible for Medicare Part B (physicians’ services) and Part D (prescription drugs).

A common mistake that people may make for different reasons is failing to sign up for Medicare at the right time. To avoid late penalties, one must sign up for Medicare during their designated Initial Enrollment Period.  Your Initial Enrollment Period is a seven-month period beginning three months before the month you turn 65 and ending three months after the month you turn 65.  This is true even if your “full retirement age” for Social Security retirement benefits is age 66

Sometimes people hear about the Medicare “Open Enrollment Period” in the fall of each year and believe that this is when they should first sign up for Medicare. Actually, Open Enrollment is when people who are already receiving Medicare may change their Medicare coverage or plan for the following year. First-time Medicare enrollees must sign up during the three month period before and after they turn 65.  One legitimate reason to delay signing up for Part B is if you continue to have health coverage from an employer after age 65; in this case you can delay enrollment in Part B with no penalty.

Finally, it would be a mistake to decide not to sign up for Part D just because you do not currently take any prescription medications. An unforeseen medical condition could necessitate expensive prescriptions, and having a Part D plan can be crucial.

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Seniors are often targeted for identity theft, telemarketing and sweepstakes fraud, and home improvement rip-offs. And with so many seniors using the Internet, online scams are an increasing concern.

That’s why Westchester County launched Senior Crime Busters, a proactive elder fraud and crime prevention program that teaches seniors how to recognize potential scams before they happen, and how to avoid becoming a victim in the first place. To learn more about this program, visit the Westchester County Senior Citizens website or click here.

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May 2014 is Older Americans Month, with the theme of “Safe Today, Healthy Tomorrow.”

Older Americans Month, once known as Senior Citizens Month, has been celebrated since 1963, and is a time to honor older Americans for their contributions and achievements, and raise awareness of issues of importance to seniors.

In New York, a ceremony will be held on Tuesday, May 6 in Albany, to mark Senior Citizens’ Day and Older Americans Month. Older citizens from across the state will be honored by the New York State Office for the Aging, focusing on those who have shared their expertise with their communities through volunteer work.

This year the theme of Older Americans Month is a focus on safety. Seniors are at a much greater risk of unintentional injury than the rest of the population. Falls and other accidents account for millions of injuries and over 30,000 deaths each year.

There are many small changes that older Americans can make to promote safety. These include having one’s vision checked on a regular basis, staying aware of medications that may cause unsteadiness, installing handrails in bathrooms or wearing shoes with non-slip soles to prevent falls, and setting the household water heater to 120 degrees to prevent burns. Seniors should also be aware that daytime driving under good weather conditions is safest, and it is important to avoid distractions while driving.

The Administration for Community Living, which helps seniors live in their homes and participate in their community, has additional resources available at http://acl.gov/olderamericansmonth.

Emergency rooms are designed for fast treatment of serious or life-threatening conditions.  Elderly patients suffering from chronic illnesses may not always be able to convey important medical information to treating professionals.  This is particularly true of those suffering from Alzheimer’s disease or dementia. Additionally, elderly patients may not be able to properly communicate information about their prescribed medications. These factors mean that quick treatment is not always the most effective treatment.

Patients coming to hospital emergency rooms receive treatment and are sent home with detailed instructions about arranging their own follow-up care. This approach is grounded in the efficient use of limited resources. For many elderly patients, this approach may not be ideal because more thorough evaluation is necessary.

Specialists in geriatric medicine and emergency room care have taken steps to address the problem. Recently, the Society for Academic Emergency Medicine (SAEM) published a set of guidelines to help emergency departments provide better care for elderly patients.

The purpose is to “provide a standardized set of guidelines that can effectively improve the care of the geriatric population and which is feasible to implement in the ED. These guidelines create a template for staffing, equipment, education, policies and procedures, follow-up care, and performance improvement measures.”  (Society for Academic Emergency Medicine, 2014)

The guidelines include better training for hospital staff to recognize certain factors that play a role in providing care to the elderly. For instance, older patients may need more assistance getting prescriptions filled, and may need for transportation to be arranged for follow-up medical visits. The guidelines also recommend sound-absorbing materials and non-slip flooring in emergency rooms to reduce noise and prevent accidents.

Recommended changes also include printing discharge instructions in a large font size, and making sure that emergency rooms communicate important information to the patient’s family and any outpatient caregivers, including nursing homes. Emergency departments should also develop relationships with providers of resources that patients can use for follow-up care regarding mobility, safety assessments, prescription assistance and education, and home health care assistance. The guidelines stress that much depends on educating hospital staff about the needs of elderly patients.

Similar changes have been made in regard to pediatric and cardiac emergency care, but changes to help the elderly have not come as quickly. Nevertheless, progress is being made. Today over 50 medical centers have made such improvements, as opposed to ten years ago, when there were no such features.

Society for Academic Emergency Medicine. (2014). Geriatric Emergency Department Guidelines. Retrieved from saem.org: http://www.saem.org/education/geriatric-ed-guidelines