Visiting Grandma at the Nursing Home

In spots where visits have resumed, they’re much changed from those before the pandemic. Nursing homes must take steps to minimize the chance of further transmission of COVID-19. The virus has been found in about 11,600 long-term care facilities, causing more than 56,000 deaths, according to data from the Kaiser Family Foundation.

AARP’s recent article entitled “When Can Visitors Return to Nursing Homes?” explains that the federal Centers for Medicare and Medicaid Services (CMS) has provided benchmarks for state and local officials to use, in deciding when visitors can return and how to safeguard against new outbreaks of COVID-19 when they do. The CMS guidelines are broad and nonbinding, and there will be differences, from state to state and nursing home to nursing home, regarding when visits resume and how they are handled. Here are some details about the next steps toward reuniting with family members in long-term care.

When will visits resume? As of mid-July, 30 states permitted nursing homes to proceed with outdoor visits with strict rules for distancing, monitoring and hygiene. The CMS guidelines suggest that nursing homes continue prohibiting any visitation, until they have gone at least 28 days without a new COVID-19 case originating on-site (as opposed to a facility admitting a coronavirus patient from a hospital). CMS says that these facilities should also meet several additional benchmarks, which include:

a decline in cases in the surrounding community
the ability to provide all residents with a baseline COVID-19 test and weekly tests for staff
enough supplies of personal protective equipment (PPE) and cleaning and disinfecting products; and
no staff shortages.

Where visits are permitted, it should be only by appointment and in specified hours. In some states, only one or two people can visit a particular resident at a time. Even those states allowing indoor visits are suggesting that families meet loved ones outdoors. Research has shown that the virus spreads less in open air.

Health checks on visitors. The federal guidelines call for everyone entering a facility to undergo 100% screening. However, the CMS recommendations don’t address testing visitors for COVID-19.

Masks. The federal guidelines say visitors should be required to “wear a cloth face covering or face mask for the duration of their visit,” and states that allow visitation are doing so. The guidelines also ask nursing homes to make certain that visitors practice hand hygiene. However, it doesn’t say whether facilities should provide masks or sanitizer.

Social distancing. The CMS guidelines call on nursing homes that allow visitors to ensure social distancing, but they don’t provide details. States that have permitted visits, state that facilities enforce the 6-foot rule.

Virtual visits. Another option is to make some visits virtual. Videoconferencing and chat platforms have become lifelines for residents and families during the pandemic. Continued use after the lockdowns can minimize opportunities for illness to spread.

Reference: AARP (July 22, 2020) “When Can Visitors Return to Nursing Homes?”

How Do I Keep Up My Spirits in the Pandemic?

The coronavirus has created some stressful situations that can bring out the best or worst in us. We must hope that the pandemic will eventually be brought under control, and our loved ones will survive.

AARP’s recent article entitled “Keeping Caregiver Spirits High During the Coronavirus Outbreak” says that there’s no single way to find hope.

Many family caregivers draw on their faith, and others on rely on sheer determination. However, there some other ways to create hope for caregivers and their loved ones in this pandemic.

The article provides some psychological ideas:

Watch your temperament. Through our disposition and upbringing, each one of us is inclined to look at the world as a pessimist or an optimist. These tendencies become more pronounced under the stress of a crisis. To get a sense of your natural tendency, keep a daily journal and record your current preoccupying thoughts. Keep that document and review it in a week. Rereading those entries will quickly let you know where you stand psychologically and let you to see if you need to take steps to better deal with the current pandemic.

Change your mindset. Since optimism is better, make an effort to increase your optimistic thinking. You could bring your attention more fully to some of the unforeseen benefits of this change in our normally hectic lives. Keeping a gratitude journal is another way of heightening your awareness of the good things we still have.

Rearrange your activities. Directing your activities can result in a more hopeful outlook. Don’t watch hours of cable news shows, because it can have a negative effect on your psyche. Keep informed but balance news with engaging in fun activities.

Contact your positive-minded friends. It is more crucial than ever to virtually contact your friends and family members for support by sharing experiences, fears and good wishes. Reach out to those who can sustain a more balanced and realistic view, acknowledging these negative times but also the positive possibilities.

Reference: AARP (March 31, 2020) “Keeping Caregiver Spirits High During the Coronavirus Outbreak”

Will I Live Longer, if I Babysit the Grandchildren?

There’s a growing body of research that supports the notion that grandparents who babysit a grandchild live longer. Parents with young children can know that their parents and their children are getting benefits from babysitting time together, says Considerable’s June article entitled “Grandparents who babysit a grandchild live longer, study finds.”

Considerable spoke with Dr. David Coall, senior lecturer at Edith Cowan University and a co-author of a 2017 study that found a connection between grandparent caregiving and mortality. Dr. Coall gave some updates in the field and highlighted further connections that still need to be made.

The 2017 study that Dr. Coall co-authored analyzed date from the Berlin Aging Study (BASE), which monitored the health and social conditions of over 500 participants in Germany between 1990 and 2009. The study focused on grandparents who simply provided periodic babysitting, rather than primary caregiving for their grandchildren.

Dr. Coall’s team of researchers found that caregiving grandparents had a 37% lower risk of death than non-caregiving grandparents. The same 37% risk reduction in mortality was found when comparing caregiving grandparents with non-grandparents.

Therefore, the risk of dying over a 20-year period was a third lower for grandparents who provided some level of care for their grandchildren, as opposed to grandparents who provided no care at all.

According to Dr. Coall, “The obvious next question was, ‘Is that purely because healthier grandparents are more likely to babysit and live longer?’”

In August 2017, he used the same BASE data to see if grandparents were healthier due to babysitting, or if they were babysitting, because they were already healthier and able to do so. Dr. Coall found that health only accounted for 22% of the link between helping and longevity. Interestingly, a direct effect of babysitting on longevity still existed in the data.

“So, we continue to look for what could be making this link between helping and living longer.”

Some longitudinal studies have examined if babysitting is linked with a subsequent improvement in grandparental health, with mixed results. The most recent study, a collaboration with researchers in Finland that was published in July, looked at whether an individual who became a grandparent subsequently went on to enjoy improved health.

Dr. Coall said that the research shows “a specific improvement in physical health, but not in emotional or mental health. Maybe this works through increased activity levels looking after grandchildren.”

Reference: Considerable (June 23, 2020) “Grandparents who babysit a grandchild live longer, study finds”

How Can I Combat the Social Isolation of Coronavirus?

Local and state governments are asking that we socially distance ourselves to prevent the spread of the coronavirus.

The CDC recommends that anyone who’s age 60 and older avoid crowds, and that those in a community with an outbreak remain at home as much as possible.

AARP’s recent article entitled “How to Fight the Social Isolation of Coronavirus” gives us some ideas to keep in mind to decrease the threat of social isolation and loneliness as the pandemic continues:

Social isolation and loneliness are significant health issues. These related conditions impact a great number of adults in the U.S. It is thought of as being the equivalent of smoking 15 cigarettes a day! According to research from the National Academies of Sciences, Engineering and Medicine, 43% of adults over 60 in the U.S. reported feeling lonely.
Prepare and stay in contact. It’s crucial that we talk to family and friends to develop a plan to safely stay in regular touch, as we socially distance ourselves—or if required to self-quarantine for a possible exposure or are in isolation for a COVID-19 infection. This should confirm whom you can contact, if you need help getting food, medicine and other supplies.
Find helpful organizations. Create a list of charitable and other local organizations that you or the people in your plan can contact, if access is needed to information, health care services, support and resources.
Don’t forget about pets. Pets are a great source of love and companionship, and they can help combat loneliness. In fact, some pets have been linked with owners’ longevity. Just as you need to be sure you have enough supplies for you and family, be stocked with food and other supplies for your furry friends.
Keep in mind those who are at the greatest risk for social isolation and loneliness. People with the highest risk of serious illness from COVID-19 and who should be the most aware of social distancing, will also be the most at risk of increased social isolation and loneliness. While planning is important, know that many individuals will likely experience increased social isolation and loneliness.

Reaching out to friends, family, and neighbors can help protect all of us from COVID-19, as well as social isolation and loneliness.

Reference: AARP (March 16, 2020) “How to Fight the Social Isolation of Coronavirus”

Can I Get Paid to Be a Caregiver for a Family Member Who’s a Vet?

AARP’s recent article entitled “Can I Get Paid to Be a Caregiver for a Family Member?” says that you may be able to get paid to be a family caregiver, if you’re caring for a veteran. Veterans have four plans for which they may qualify.

Veteran Directed Care. Similar to Medicaid’s self-directed care program, this plan lets qualified former service members manage their own long-term services and supports. Veteran Directed Care is available in 37 states, DC, and Puerto Rico for veterans of all ages, who are enrolled in the Veterans Health Administration health care system and require the level of care a nursing facility provides but want to live at home or the home of a loved one. A flexible budget (about $2,200 a month) lets vets choose the goods and services they find most useful, including a caregiver to assist with activities of daily living. The vet chooses the caregiver and may select any physically and mentally capable family member, including a child, grandchild, sibling, or spouse.

Aid and Attendance (A&A) Benefits. This program supplements a military pension to help with the expense of a caregiver, and this can be a family member. A&A benefits are available to veterans who qualify for VA pensions and meet at least one of the following criteria. The veteran:

Requires help from another to perform everyday personal functions, such as bathing, dressing, and eating
Is confined to bed because of disability
Is in a nursing home because of physical or mental incapacity; or
Has very limited eyesight, less than 5/200 acuity in both eyes, even with corrective lenses or a significantly contracted visual field.

Surviving spouses of qualifying veterans may also be eligible for this benefit.

Housebound Benefits. Veterans who get a military pension and are substantially confined to their immediate premises because of permanent disability are able to apply for a monthly pension supplement. It’s the same application process as for A&A benefits, but you can’t get both housebound and A&A benefits simultaneously.

Program of Comprehensive Assistance for Family Caregivers. This program gives a monthly stipend to family members, who serve as caregivers for vets who require help with everyday activities because of a traumatic injury sustained in the line of duty on or after Sept. 11, 2001. The vet must be enrolled in VA health services and require either personal care related to everyday activities or supervision or protection, because of conditions sustained after 9/11. The caretaker must be an adult child, parent, spouse, stepfamily member, extended family member or full-time housemate of the veteran.

Reference: AARP (May 15, 2020) “Can I Get Paid to Be a Caregiver for a Family Member?”

Does Long-Term Care Impact COVID-19 Infection Rates?

The National Investment Center for Seniors Housing and Care (NIC) say that research supports the finding that keeping older Americans in apartments of their own may be saving many of them from COVID-19. That’s a summary of results from a survey of more than 100 senior housing and care operators.

Think Advisor’s recent article entitled “LTC Type Has Big Effect on COVID-19 Infection Rates: Provider Survey” explains that some participants provide more than one type of long-term care (LTC) services.

The sample includes 56 assisted living facility managers and 29 nursing home managers, as well as providers of some other types of services.

The assisted living facility managers said that they’d tested 22% of the residents as of May 31, and only 1.5% had confirmed positive, or suspected positive, COVID-19 tests.

The nursing home managers tested 34% of their residents.

Roughly 6.7% of the residents tested had confirmed or suspected positive coronavirus tests.

Analysts at the Foundation for Research on Equal Opportunity believe that, as of June 19, approximately 43% of the people who’ve died from COVID-19 in the U.S. have been in nursing homes and assisted living facilities.

Many seniors with private long-term care insurance (LTCi) policies, short-term care insurance policies, or life insurance policies, or annuities that provide LTC benefits attempt to use the policy benefits to stay at home as long as possible, or to live in the least restrictive possible LTC setting.

The NIC survey results support the finding that access to private LTCi and LTC benefits may have protected some insureds from the COVID-19 outbreak.

Reference: Think Advisor (June 29, 2020) “LTC Type Has Big Effect on COVID-19 Infection Rates: Provider Survey”

Should Nursing Homes Plan for Future Pandemics?

Roughly 6,000 nursing home residents have died during the pandemic in New York State.

The coronavirus pandemic has exposed vulnerabilities for one of the country’s most high-risk populations: our senior citizens.

Spectrum News reports in the article “Nursing Homes Could Be Required to Have Pandemic Plan” reports that a proposed bill in that state would require nursing homes to have plans for future pandemics, make those plans readily available on websites, provide regular updates on the status of patients and establish protection plans for staff and residents.

In addition, communication via videoconferencing must be made available for residents.

The bill would also mandate that a pandemic plan preserve a resident’s place in a nursing home after hospitalization is through. It would also include provisions for the facilities to have a minimum two-month supply of personal protective equipment (PPE).

The New York State Department of Health will be required to audit facilities annually for compliance.

“The nature of COVID19 exposed a tragic vulnerability among one of our most high-risk populations: our elderly,” said Assemblyman Joe Lentol, a Brooklyn Democrat. “The rapid spread of the virus in nursing homes exposed a fatal flaw in pandemic planning and it is clear that more has to be done to protect nursing home residents and its healthcare workers.”

New York’s response to nursing homes during the crisis has come under some scrutiny. Part of that has been a March 25 order that required the facilities to take in COVID-positive patients.

New York Governor Andrew Cuomo has partially reversed that directive, by banning hospitals from discharging people to nursing homes who are still positive for the virus.

Cuomo has also placed some of the blame on the CDC guidelines for permitting nursing homes to take COVID residents. However, he didn’t raise the issue in a recent meeting with President Trump.

Twice weekly testing of nursing home and adult care facility staff is now underway. The testing capacity and supply has increased in New York over the past month.

The bill must still be considered by Governor Cuomo for approval.

Reference: Spectrum News (May 28, 2020) “Nursing Homes Could Be Required to Have Pandemic Plan”

Suggested Key Terms: Elder Law Attorney, Elder Care, Caregiving, Legislation

Why was Widow of Henry Ford II in a Fight over the Estate?

Henry Ford II’s heirs say that his attorney, Frank Chopin, tried to control their access to Ford’s 80-year-old widow, Kathleen DuRoss Ford.

Her daughters, Kimberly DuRoss and Deborah DuRoss Guibord, alleged that Chopin abused her, by “[forcing] pills down her throat.”

The Wealth Advisor article entitled “Ford Heirs Lose Battle to Oust Mother’s Allegedly Abusive Caregiver” explains that Chopin has power of attorney over the widow’s affair and denies the allegations.

A Palm Beach, Florida judge denied their request to have Chopin removed as her caregiver. It was a decision that left her daughters, grandchildren and even her 82-year-old sister, Sharon, distraught.

Tara DuRoss, a 23-year-old granddaughter of Ford’s, said that Chopin had restricted her time with her relatives. They were forced to scheduled conference calls and meetings away from her home. However, the calls then stopped.

“I used to call her every day. We just want to be able … to see her.”

Chopin said that it is untrue that Tara spoke to Kathleen daily. He called her an “idiot child,” and said the family was “estranged,” unless “they wanted something.”

Kathleen DuRoss Ford passed away on May 9.

Henry Ford II was also known as “HF2” or “Hank the Deuce.” He was the eldest son of Edsel Ford and eldest grandson of Henry Ford of the leading family in the American automotive industry.

After his death from pneumonia in 1987, DuRoss Ford was involved in a public fight over the fate of the estate, which was then thought to be at least $350 million. The legal battle eventually settled, and she received an annual allowance that was worth millions of dollars.

Reference: Wealth Advisor (March 31, 2020). “Ford Heirs Lose Battle to Oust Mother’s Allegedly Abusive Caregiver”

Will the Sunshine State Crack Down on Crimes against the Elderly?

Florida Governor Ron DeSantis signed a bill recently approving the creation of elder abuse fatality review teams.

These teams are authorized by Senate Bill 400, which permits, but doesn’t require the creation of elder death review teams in each of Florida’s 20 judicial circuits. The teams would review cases in their judicial circuit where abuse or neglect has been found to be linked to or the cause of an individual’s death.

The Naples Daily News’ recent article entitled “Deaths of Florida’s elderly who were abused or neglected to get increased scrutiny under new law” reports that for many years, the state has authorized teams to examine child deaths and domestic-violence deaths where abuse is involved. However, the state hasn’t had a comparable review when an elderly adult dies, even under suspicious circumstances.

State Senator Audrey Gibson, D-Jacksonville, has sponsored the bill for the last four years and remarked that it’s “incumbent upon us as a state” to review cases of elder abuse and to look for gaps in service and possible policy changes to better protect the elderly.

“It can help to reduce elder abuse, if somebody knows that it’s going to be up for review if something happens to that senior,” said Gibson, the Senate minority leader. “The other thing is to prevent what happened in the cases they’re reviewing, to keep that from happening to another senior.”

Elder advocates believe that the new elder death review teams could help decrease the number of cases of nursing home neglect and mistreatment, like those identified in a recent USA TODAY Network – Florida. The investigation looked at 54 nursing home deaths from 2013 through 2017 where state inspectors cited neglect and mistreatment as factors.

The investigation found that Florida’s Agency for Health Care Administration seldom investigated the deaths.

The new law states that these elder abuse fatality review teams can be established by state attorneys and would be part of the Department of Elder Affairs. They would be composed of volunteers and open to people from a variety of disciplines, such as law enforcement officers, elder law attorneys, prosecutors, judges, nurses and other elder care advocates.

The teams are restricted to looking at files that have been closed by the State Attorney’s Office, whether or not it resulted in criminal prosecution. Remarkably, state attorneys didn’t prosecute any of the 54 nursing home deaths reviewed in the network’s investigation.

Reference: Naples Daily News (June 11, 2020) “Deaths of Florida’s elderly who were abused or neglected to get increased scrutiny under new law”

Estate Planning Blog Articles

Estate & Business Planning Law Firm Serving the Providence & Cranston, RI Areas

Visiting Grandma at the Nursing Home

How Do I Keep Up My Spirits in the Pandemic?

Will I Live Longer, if I Babysit the Grandchildren?

How Can I Combat the Social Isolation of Coronavirus?

Can I Get Paid to Be a Caregiver for a Family Member Who’s a Vet?

Does Long-Term Care Impact COVID-19 Infection Rates?

Should Nursing Homes Plan for Future Pandemics?

Why was Widow of Henry Ford II in a Fight over the Estate?

Will the Sunshine State Crack Down on Crimes against the Elderly?

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Visiting Grandma at the Nursing Home

How Do I Keep Up My Spirits in the Pandemic?

Will I Live Longer, if I Babysit the Grandchildren?

How Can I Combat the Social Isolation of Coronavirus?

Can I Get Paid to Be a Caregiver for a Family Member Who’s a Vet?

Does Long-Term Care Impact COVID-19 Infection Rates?

Should Nursing Homes Plan for Future Pandemics?

Why was Widow of Henry Ford II in a Fight over the Estate?

Will the Sunshine State Crack Down on Crimes against the Elderly?

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