How Do Healthcare Professionals Help Aging Veterans Cope?

As our veteran population grows older, some will require mental health professionals to help them continue to live their best lives. Daily Nurse’s recent article entitled “Help Aging Veterans Cope with a Geriatric Mental Health Career” says that when it comes to providing for our aging veterans’ mental health, geriatric psychiatrists bring unique expertise to our team.

They focus on the prevention, evaluation, diagnosis and treatment of mental and emotional disorders in the elderly. However, the big difference for geriatric professionals is their experience with older adults who have multiple medical issues and take multiple medications.

Aging vets may have depression, anxiety, distressing memories from their military service, or stress related to health concerns. This may present as pain, trouble sleeping, or memory issues.

“Having access to a specialist who not only understands psychiatric medicine but the pharmacological goals of the elderly we care for has made a tremendous difference in our ability to keep our Veterans stabilized and safe in our memory care unit,” explained Edith Emerson, who works in the memory care unit at the Togus Maine VA.

The VA has a number of programs to support older veterans and their families and caregivers, both online and in-person at their facilities. They also provide specialized geriatric services for veterans and families to help them cope with complex mental health conditions in later life. However, the need for geriatrics professionals throughout the country is growing.

There are more than 11 million people aged 60 and older alive today who have served in the military, representing the largest population of veterans in the nation.

“Nationwide, there’s a shortage of geriatric services, in particular geriatric psychiatry,” said Dr. Isis Burgos-Chapman, a geriatric psychiatrist who provides community living center and outpatient consultation services through one of VA’s Clinical Resource Hubs.

With telehealth services, inpatient care positions and outpatient care support opportunities, there are many ways a mental health professional with a focus on geriatrics can reach out to aging veterans and demonstrate our core values—integrity, commitment, advocacy, respect, and excellence

Reference: Daily Nurse (Jan. 27, 2023) “Help Aging Veterans Cope with a Geriatric Mental Health Career”

Should I Consider Working with an Elder Law Attorney?

Partnering with an elder law expert is the best way to make life transition easier as seniors age. RC Online’s recent article entitled “Why Is It Ideal for Working with An Elder Law Attorney During Life Transitions?” explains that many people have issues in the stage of life when they’re weak and not feeling well. This can result in health or mobility issues for many family members. The challenges faced by the family can cause financial strain, making lifestyle adjustments difficult, the article says.

Elder law attorneys can help family caregivers understand their loved one’s current situation and provide possible future solutions. This includes planning for situations where a debilitating illness requires long-term care.

Elder law attorneys often see various financial and medical circumstances when representing seniors in court, so their assistance can be extremely valuable when addressing issues, such as managing long-term care needs.

Specialized services for elderly care. Elder law attorneys focused on legal matters concerning older individuals. An elderly law attorney will be familiar with the elder laws of your state and will be able to identify potential conflicts or issues easily. As a result, they’ll be able to take appropriate actions to protect their client’s interests and rights.

Long-term care plan development for seniors. An elder care attorney can provide an objective perspective on the kind of care for their elders. This can help create a longevity plan that meets everyone’s needs.

The attorney will focus on families’ issues and problems as parents or spouses age. They provide legal services to individuals facing aging challenges, such as health care decisions and financial planning. An elder law attorney will consider the required level of care and whether a person can remain in their own home or require long-term nursing care.

Help for families in mediation and education. These are critical parts that play an important role during a family’s transitional phase. Mediation helps families maintain communication, and education provides knowledge for handling various issues.

It is important to have legal agreements related to retirement benefits, assets and who will be responsible for caring for an elderly loved one. An elder law attorney can help make these arrangements to prevent family fights and protect assets. They can assist seniors as well as heirs and beneficiaries to prevent losing assets due to financial problems or other circumstances.

Reference: RC Online (Feb. 14, 2023) “Why Is It Ideal for Working with An Elder Law Attorney During Life Transitions?”

What Documents are Included in Advance Care Planning?

Starting discussions earlier helps ensure that a person with dementia stays involved and understands the planning process. In the same fashion, regular reviews of plans over time are beneficial for ensuring that their wishes are carried out.

Health News’ recent article entitled “Can Someone With Dementia Sign Legal Documents?” cautions that, when family members don’t know the preferences of their loved one, they have difficulties and stress in making decisions. Family members may also have feelings of guilt, self-doubt and stress while making advanced care decisions.

Laws in each state may differ. Working with an experienced elder law attorney can help seniors interpret state laws, plan how wishes should be carried out and understand financial options.

Geriatric care managers, trained social workers, or nurses can also offer support to those living with dementia, as well as their families.

While advance care planning, families and their loved ones with dementia should create a plan for long-term care and plan for funeral arrangements in advance.

Advance care planning documents commonly include the following:

A durable power of attorney for healthcare names someone to function as a proxy for the person with dementia, when he or she may be unable to make healthcare decisions for themselves.
A living will includes an individual’s wishes for end-of-life treatment. This can concern specific procedures such as dialysis, tubal feeding, or blood transfusion. If the person becomes permanently unconscious (coma), families can make treatment decisions based on wishes expressed in a living will.
A do-not-resuscitate order (DNR) is put with a patient’s chart when the patient doesn’t want to receive cardiopulmonary resuscitation (CPR) if their heart stops or breathing ceases. A doctor needs to sign these DNR orders before they can be placed in the patient’s charts.

Advance care planning can be a sensitive topic for families and those with dementia.

Getting medical and legal advice early is helpful in planning advance care. Involving the person with dementia in the planning process also helps families ensure that the wishes of the patient are respected.

Reference: Health News (Jan. 11, 2023) “Can Someone With Dementia Sign Legal Documents?”

What Is ‘Food Insecurity’?

“The pandemic has exacerbated existing trends in food insecurity,” Cindy Leung, ScD, MPH, assistant professor of public health nutrition at the Harvard T.H. Chan School of Public Health, in Boston, said in an email. “People who were already experiencing food insecurity found themselves at more severe levels, and other people were experiencing food insecurity for the first time. Older adults were no exception, on top of a higher risk of COVID-related disease burden and hospitalizations.”

MedPage Today’s recent article entitled “Food Insecurity Among Older Adults Remains a Problem” explains that food insecurity, which is defined as a lack of access to a sufficient amount of nutritious foods, was an issue in the U.S. even before the pandemic started.

Leung and her then-colleagues at the University of Michigan conducted a survey of about 2,000 older adults in 2020 that found that 14% of those ages 50-80 had experienced food insecurity in 2019. This appeared to be connected to worse physical and mental health, the researchers reported.

“Nearly half of adults aged 50-80 who were food insecure rated their physical health as fair or poor (45%), compared to 14% of those who were food secure,” while “almost a quarter of those who were food insecure reported fair or poor mental health (24%) compared to 5% of those who were food secure.”

The researchers also found that about 54% of food-insecure respondents had multiple (two or more) chronic conditions, compared to 41% of food-secure individuals. Food-insecure individuals were more likely than food-secure individuals to report having these conditions than food-secure respondents:

Asthma
Chronic bronchitis or chronic obstructive pulmonary disease
Chronic pain; diabetes
Kidney disease; or
A sleep disorder.

There were no significant differences in cancer, heart disease, high blood pressure, high cholesterol, or non-alcoholic fatty liver disease by food security status, however, they noted.

“Food insecurity is actually a really big problem among older adults,” Nicole Heckman, vice president of benefits access at the AARP Foundation, said in a phone interview at which a press person was present. “Nearly 9.5 million adults ages 50 and older are food insecure.”

Heckman gave several reasons for the problem. “One is obviously a lack of income,” she said. “Those that are at or below the poverty line struggle to afford the food they need, especially when we think about the inflation and just the crazy food prices and how much they have gone up over the last 2 years.”

The federal government addressed the general issue of food insecurity during the pandemic in part by expanding access to food programs like the Supplemental Nutrition Assistance Program (SNAP), as well as expanding the dollar value of available benefits. However, Heckman said, “many older adults aren’t actually aware of the programs and benefits to help them put food on their table. Research shows there are over three million older adults that missed out on more than $200 a month in SNAP benefits” during the pandemic.

Reference: MedPage Today (Jan. 10, 2023) “Food Insecurity Among Older Adults Remains a Problem”

How to Find New Doctor for Mom if She Moves

Seasons’ recent article entitled “How do I help an older adult switch doctors after a move?” advises that breaking the process into manageable pieces will help you make sure you don’t miss any details.

First, check mom’s insurance because Medicare options are different when moving states. Check with Medicare to determine the process based on your mom’s existing coverage. Then you can find new health care providers.

Caregivers should have at least one dedicated three-ring notebook with dividers specifically for their loved one’s important information. Two is even better: one for financial information and one for medical information. Separate notebooks allow you to take the one with medical information to appointments without having sensitive financial information out and about at appointments.

Place some blank calendar pages in the front of the medical notebook. You’ll be able to organize your mom’s appointments in one place, as well as have a record of past appointments.

If you also use an online calendar like Google Calendar or iCalendar, create a color specifically for your mom’s appointments, so you can easily see the dates and times of her appointments.

Try using the paper option even if you also use an online calendar because this makes certain the information is easily accessible in case you need to share information with another person who helps with the caregiving.

Having all of your loved one’s medical information in one place that’s easily accessible will be invaluable when going to appointments at different doctors’ offices. You’ll have all of the info ready to share with different medical providers.

Once you get a system started to keep your mom’s information in an easily accessible place, it will be a pretty simple process to keep doctor appointments and medical information organized.

Reference: Seasons (Nov. 28, 2022) “How do I help an older adult switch doctors after a move?”

How to Manage Aging Parent’s Finances

A day will come when age begins to catch up with your parents and they will need help with their finances. Even if your parents don’t want to feel dependent, when you think they need your assistance, you can approach the issue with sensitivity and extend your support for the management of their finances, says Real Daily’s recent article entitled “5 Tips to Manage an Aging Parent’s Finances.” Here are some tips:

Start the conversation early. Your parents may not need your help with the handling of their financial matters right away. However, it is smart to begin the conversation early. Approach the issue of who will manage the financial responsibilities when they’re no longer able to do it. Parents should select a trusted family member by providing their advance written consent. This will let you to talk about your parents’ financial issues with financial advisors, doctors and Medicare representatives and carry out timely financial planning.
Create a list of all pertinent legal and financial documents. Prepare a list of your parents’ important contacts, bank account details and locations of any stored documents, like wills, property deeds, insurance policies and birth certificates. Make certain all information and documentation is accurate and up to date. If information needs to be modified because of a change of circumstances, this is time to apprise them of it and help them do what’s needed.
Consider executing a power of attorney. A competent adult can sign a power of attorney to authorize another person to make decisions on their behalf. A power of attorney for a specific purpose may cover medical, financial, or other decisions, and it may be designed to give limited or more sweeping powers. When your parents sign a power of attorney with you named as their attorney in fact, it will legally empower you to make key decisions when they can’t. An elder law attorney can help you draft an appropriate power of attorney according to your situation.
Document your actions and keep others in the know. Transparent communication will help you avoid misunderstandings or controversy within your family. Keep your parents, siblings and any other loved ones involved with your family informed about your actions. No matter how noble your intentions may be, if others are kept in the dark, it can raise questions about your motives. Managing the finances of aging parents is a lot of work, and you can ask for the support of family members or at least keep the lines of communication open.
Don’ comingle your finances with your parents’ plans. While it may look to be a convenient or cost-effective thing to do, it’s never a good idea to combine your parents’ finances with your own. Keep them separate. Using your parents’ money for your purposes or your own money to help them out is usually a slippery slope that should be avoided. Don’t forget about your own financial goals and retirement savings while you focus on helping your parents.

Reference: Real Daily (Sep. 9, 2022) “5 Tips to Manage an Aging Parent’s Finances”

Wayward Senior Tracked by Bluetooth Technology

The Hernando County Sheriff’s Office recently received a report of a missing adult in the Hernando Beach area.

According to the agency, the elderly man, who suffers from dementia, was reported missing by his wife at about 7:30 in the morning.

Units were dispatched within minutes, reports WTSP.com, in the article entitled “’Technology is one of the best tools…’: Missing elderly man found through Bluetooth tracking device.”

The sheriff’s office said this wasn’t the first time the man has been reported missing.

This time, his wife was prepared: she attached a Bluetooth tracking device to her husband’s belt.

Bluetooth is a type of wireless technology that allows the exchange of data between different devices, such as two cellphones.

Because she planted the device, she was able to give deputies a location to where to find her husband.

Law enforcement was able to locate the man by 7:54 a.m.

He was returned safely home to his family.

“With the high heat index this time of year and the multiple access points to water in the area, we are thankful for this assistance of technology in order to locate this individual within 18 minutes,” the sheriff’s office wrote in a statement.

The sheriff’s office says tracking devices like the one used in this incident can give families peace of mind when caring for a senior with mental health issues, by being able to monitor their location.

“Whether it is a child with special needs or a senior who is forgetful, there are usually warning signs that a person is prone to wandering,” Sheriff Al Nienhuis said in a statement.

“Technology is one of the best tools family members can use to alert them when that individual has unexpectedly left the house.”

“It also provides invaluable tools to increase the likelihood the person will be returned safely. We strongly encourage families to research what technology is right for their situation.”

Reference: WTSP.com (August 8, 2022) “’Technology is one of the best tools…’: Missing elderly man found through Bluetooth tracking device”

Elderly Woman Thanks Firefighters for Ride to Visit Husband at Nursing Home

An senior in San Diego was so grateful for the help of local firefighters, she wanted to thank them in person with a big bag of sweets, reports NBC San Diego’s recent article entitled “Stranded La Jolla Woman, 87, Brings Treats to Firefighters Who Gave Her a Lift.”

“It was a long time I was waiting for that cab. If it wasn’t for you, I’d be there all night,” La Jolla resident Sandy Lightman recalled telling San Diego Fire-Rescue Department Captain Jordan Buller on May 10, the night of her “rescue.”

The article said that Mrs. Lightman may have needed a fire engine to haul the three dozen cookies and four cheesecakes to Captain Buller and the Station 35 crew.

The 87-year-old explained that she’d just ended one of her daily trips to a nursing facility, where she cares for her husband who’s living with dementia.

She started requesting a cab around 8:20 p.m., but it didn’t show. So, she kept calling.

Hours later at 11 p.m., while on another call to the facility, Captain Buller and his crew recognized Lightman’s distress.

“She was frantically trying to call family and call a cab and we could tell she was distraught,” he said.

“I can’t walk that well, and I was only two-and-a-half blocks from where I live but I was afraid to go on the street by myself. I didn’t know if I’d make it home,” she said.

Since the cab wasn’t coming, the San Diego fire firefighters loaded Lightman into the cab of their engine.

They strapped her into the jump seat—and even gave her headphones to wear for the trip.

“It felt so secure, it made me feel so good because they were helping me and I knew I was safe, because I was afraid,” said Mrs. Lightman.

Back home safely, the grateful woman says she’s thankful to the local news outlet that was able to help track down the station who treated her with such kindness, so she could spoil them with some sweet treats.

Lightman and her husband will celebrate 40 years of marriage next week.

Reference: NBC San Diego (May 24, 2022) “Stranded La Jolla Woman, 87, Brings Treats to Firefighters Who Gave Her a Lift”

What Do I Need to ‘Age in Place’?

Home modification is the official term (from the Americans with Disabilities Act) for renovations and remodels aimed for use by the elderly or the impaired. It means physically changing your home, removing potential hazards and making it more accessible, so you can continue living in it independently.

Bankrate’s recent article entitled “The best home modifications for aging in place” reports that home modifications can be pricey—typically ranging from $3,000 to $15,000, with the average national spend being $9,500. However, it can be a worthwhile investment. You can save money by doing the right home modifications. That is because the longer you can safely live in your home, the less you will need to pay for assisted living care.

The best aging-in-place home modifications align with “universal design,” an architectural term for features that are easy for all to use and adaptable, as needs dictate. This includes additions and changes to the exterior and interior of a home. Some of the simplest home modifications include DIY jobs:

Adding easy-grip knobs and pulls, swapping knobs for levers
Installing adjustable handheld shower heads
Rearranging furniture for better movement
Removing trip hazards; and
Installing mats and non-slip floor coverings.

Next, are some more complex home modifications. These probably would need a professional contractor, especially if you want them up to code standards:

Installing handrails
Adding automatic outdoor lighting
Installing automatic push-button doors
Leveling flooring; and
Installing doorway ramps

There are also home modifications that can be done by room:

In the bathroom, installing grab bars and railing, a roll- or walk-in shower/tub, or a shower bench
In the kitchen: adding higher countertops, lever or touchless faucets and cabinet pull-out shelves
For the bedroom, use a less-high bed, non-slip floor, walk-in closets and motion-activated lights
Outside, you can add ramps, a porch or stair lifts, and automatic push button doors.

Finally, throughout the house, keep things well-lit and widen hallways and doorways; add a first-level master suite, elevators or chair lifts, “smart” window shades/thermostats/lighting and simpler windows.

Note that some home modifications may qualify as medical expenses. As a result, they are eligible for an itemized deduction on your income tax return. A home modification may be tax-deductible as a medical expense, if it has made to accommodate the disabilities (preferably documented by a physician or other health care provider) of someone who lives in the home, according to the IRS.

Reference: Bankrate (March 30, 2022) “The best home modifications for aging in place”

Can I Avoid the Economic Dangers of Caregiving?

AARP’s recent article entitled “5 Steps to Avoid Economic Pitfalls of Caregiving” reports that 20% of family caregivers have to take unpaid time off from work due to their caregiving responsibilities.

The average lifetime cost to caregivers in lost wages and reduced pension and Social Security benefits is $304,000 — that is $388,000 in today’s dollars. This does not count the more than $7,200 that most caregivers spend out of pocket each year, on average, on housing, health care and other needs for loved ones in their care, according to the AARP report.

Step 1: Calculate the gap. The average cost of a full-time home health aide is nearly $62,000 a year, and a semiprivate room in a nursing home runs about $95,000. Ask your parents about the size of their nest egg, how fast they are spending it, whether they have long-term care insurance and how much equity they have in their home. Compare your parents’ assets against their projected expenses to determine your gap.

Step 2: Fill the gap without going broke. Try to find free resources: Use the National Council on Aging’s BenefitsCheckUp tool to find federal, state and private benefit programs that apply to your situation. Then create a budget to determine what you can contribute, physically and in dollars, to closing the gap. In addition, ask your siblings if they can pitch in.

Step 3: If a gap remains, consider Medicaid. This program can cover long-term care. However, your parent or parents may need to spend down assets to qualify. Note that if just only one parent is in a nursing home, the other can generally keep half of the assets, up to a total of $137,400 (not including their house). However, the rules differ by state. As a result, this can get complicated. Speak with an elder-law attorney for help.

Step 4: No matter what the gap, try to get paid. If your parents have enough resources, you may discuss having them pay you for caregiving. However, you should speak with an attorney first about drawing up a contract. This should include issues like the number of hours a day you will spend on providing care and whether doing so will require you to quit your job. The caregiving agreement is written carefully, so that it does not violate Medicaid regulations about spending down assets.

Step 5: Protect your own earning ability. If you are mid-career, it is very difficult to leave a job for family responsibilities like caregiving and then go back into the workforce at the same salary. The Society for Human Resource Management says that it costs six to nine months’ salary to replace an employee, so many employers now see it is less expensive to make an accommodation.

Reference: AARP (Feb. 24, 2022) “5 Steps to Avoid Economic Pitfalls of Caregiving”

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How Do Healthcare Professionals Help Aging Veterans Cope?