by
Rita Ude on
June 14, 2011
Discussing important issues with your parents as they grow older can be challenging. Few adult children have these conversations until a major event forces a discussion. However, waiting until a crisis happens isn’t a good planning strategy. Instead...
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by
Kathy Wetters on
February 10, 2011
With the rapid growth of the country's senior citizen population, their baby boomer children increasingly seek elder care mediators when decisions regarding issues such as their parents' health proxy, power of attorney, housing decisions and finances become contentious.
Mediation is increasingly being recommended by lawyers and judges to families for whom a temporary stalemate or long-term estrangement has ballooned into a full-blown crisis, often triggered by parental disability. Mediators say their job is not to dictate a solution but establish a framework for making decisions and to forge a consensus that fits the family.
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by
Kathy Wetters on
October 14, 2010
All morning on a cloudy summer Tuesday, poignant stories of love, courage, and selflessness fill the air at Suffolk University Law School in Boston. But the subject today isn't law. It's caregiving, encompassing all the small and large acts of kindness and support that families and friends perform for loved ones in need.
"I took care of my mother - I was her nursing home," one woman tells the nearly 100 people who have come to this Caregiver Town Hall Meeting to consider one of the biggest social and financial dilemmas the nation will face in coming years.
Other participants echo her comments. "I've been caring for my wife for seven years," one man says. Another tells of shuttling between Massachusetts and Florida for seven years to help his ailing parents. A wife talks about her six years - and counting - caring for her husband.
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by
Kathy Wetters on
October 14, 2010
The tension rose as Richard Aylward and his two sisters sorted their mother's possessions into four piles: to keep, to donate, to throw out and to move with her into an assisted living facility.
He was annoyed that his sisters wanted to reminisce about every photo and book. He wanted to hurry up and finish the job.
"Because I was the one who had to do the moving, cleaning, selling, closing, etc., I knew I had to play the heavy," he said.
Eventually, his oldest sister - fed up with her brother's pressuring - walked out.
Big sisters, little brothers, black sheep, dad's favorite - all the old roles, battles and rivalries resurface when a parent's health is failing and decisions must be made.
With about 20 million Americans providing care for a parent or in-law, such family dramas - often with financial questions lurking unsaid - are playing out across the country, said Bonnie Lawrence, spokeswoman for the Family Caregiver Alliance.
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by
Kathy Wetters on
October 14, 2010
Before my grandfather died of cancer, I helped my grandmother care for him in their home. For more than a decade, I managed health care and other financial issues for my disabled brother until his death. I also assisted with some of my grandmother's financial affairs in the years leading up to her passing. I'm currently the trustee for an older aunt.
With this experience, you would think it would be easy to talk to another adult about his care. But it's often not easy to get someone who has been living independently to open up, especially about finances.
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by
Kathy Wetters on
September 26, 2010
There is a high and increasing incidence of dementia, depression and other affective disorders, delirium, and other mental health problems, such as psychoses, among older individuals in the United States today (Luijendijk et al., 2008; Rosenberg, Woo, & Roane, 2009). Accurate and timely clinical diagnoses of these illnesses is essential for the development of optimal treatment and management plans (Kapp, 2002b). Nevertheless, because the severity of mental illness, in terms of cognitive and behavioral impairment and therefore the illness' impact on functional ability, varies for different patients at different times along a continuum (Hachinski, 2008; Okonkwo et al., 2007), there is not an automatic, precise correlation between an older person's clinical diagnosis and a simple, dichotomous determination that the individual definitively does or does not possess sufficient present capacity personally to make various sorts of fundamental life decisions. Such matters include medical care, legal transactions like executing a will or entering into a contract (Streisand & Spar, 2007), financial transactions (Hebert & Marson, 2007; Moye & Braun, 2007), living location and arrangements, and research participation (Karlawish et al., 2008). "Neuropsychological tests do not map directly on to legal constructs" (Wood, 2007, p. 202). Put differently, there frequently is a huge difference between a general psychological assessment done for diagnostic and/or therapeutic reasons on the one hand and an evaluation done for purposes of determining a person's capacity autonomously to make specific kinds of decisions on the other
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by
Kathy Wetters on
September 05, 2010
AAG has spent the last 12 months working with reverse mortgage experts, web application specialists and industry advocates to establish a revolutionary new consumer website that will make it easier for seniors to find reverse mortgage information. ReverseMortgageQA.com is a network of question and answer websites that will enable consumers to easily request free, fast, and accurate information specifically related to their individual questions about reverse mortgages. AAG spokesperson, Former Senator Fred Thompson, said, "I'm so glad seniors are being offered this new forum which allows them greater access to the facts about reverse mortgages. They can then decide if it best suits them. American Advisors Group has done an amazing job creating a venue that empowers seniors with more information and greater transparency."
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by
Kathy Wetters on
September 05, 2010
When home healthcare workers enter clients' homes, they bring more than medical care and help with daily living. They also bring the risk of liability. Whether clients slip out of their grasps in the showers or they administer the wrong medicines, home health care workers and their employers confront potential claims and lawsuits every day.
That risk is expected to increase as the home healthcare industry booms, propelled by the aging of the Baby Boomers. There will be many more home healthcare workers on the frontlines, potentially facing allegations of wrongful death, sexual abuse, medical error, negligence and inadequate monitoring.
The financial consequences of a lawsuit can be devastating, particularly for owners of smaller agencies. Right now, agents and brokers have an opportunity to educate home healthcare agencies of all sizes about insurance coverage that is relevant to them.
Home healthcare workers cover a broad spectrum, including registered and licensed practical nurses; physical, speech, respiratory and occupational therapists; hospice workers; home health aides and personal care assistants.
They provide essential care to millions of people. According to a March 2009 article from TheMedica.com, which publishes information on the healthcare industry, of the people receiving care at home, 75 percent of those receive skilled nursing care, indicating a high level of need. Also according to TheMedica.com, while the majority of people requiring home care services are 65 and older, a full 30 percent are disabled, undergoing rehabilitation, recovering from surgery or living with chronic conditions.
In light of these trends, home professional caregivers face a myriad of risks, which can lead to potential costs for a home healthcare agency. For example, a negligence claim was filed after an elderly woman fell and broke her hip. The claim resulted in a $195,000 indemnity loss. In another, a caregiver's physical abuse of a mentally challenged person resulted in $50,000 in defense costs.
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by
Kathy Wetters on
August 14, 2010
Although the American with Disabilities Act in 1990 mandated that people with disabilities (PWDs) have equal access to facilities and services, men and women with disabilities continue to report receiving inadequate health care. The need to address disability in health professions education, including nursing, has been identified by the U.S. Surgeon General, researchers, and the disability community. This study examined how disability issues are integrated in textbooks commonly used in nursing programs and differences in coverage by seven textbook categories (e.g., medical-surgical, pediatrics).A total of 33 textbooks used in undergraduate nursing curricula were systematically reviewed for inclusion of disability content using a review grid developed with the input of PWDs. Two researchers independently reviewed each textbook and at least three members of the team developed consensus ratings for each of 224 content items for each textbook. Sums of consensus ratings were calculated for each topic, each textbook, and all seven categories of textbooks. Ratings of each category of disability-related content were calculated and ranked from highest to lowest. Two investigators reviewed the consensus ratings for each category of book as well as written comments provided during the initial steps of the review.* Analysis revealed that disability-related content was largely absent from textbooks and categories of textbooks. Although disabling conditions were discussed, issues related to lifelong or preexisting disability were often not addressed. Abuse, a major issue for PWDs, was barely addressed in detail in any of the textbooks. There were significant differences (p = .005) in inclusion of disability-related content by type of textbook; the highest ranked category was community health. Topics that would be expected in specific categories were often addressed infrequently or not at all. The results of this study suggest the need for faculty members to address disability in their nursing curricula in creative ways until textbook authors and publishers begin to address this issue. The large and growing population of 60 million individuals with disabilities mandates this action.
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by
Kathy Wetters on
July 31, 2010
Depression in older adult home care recipients is frequently undetected and inadequately treated. Failed communication between home healthcare personnel and the patient's physician has been identified as a barrier for depression care. The purpose of this pilot intervention study was to improve nurse competency for communicating depression-related information to the physician. The intervention significantly improved the ability of the home care nurse to perform a case presentation in a complete and standard organized format pre versus postintervention. The intervention also increased nurse-reported certainty to communicate depression-related information to the physician.
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