Archive for Care Planning
Discussing End of Life Care (Part 2)
In part one of this two part series, we looked at the different types of advance directives people can establish to ensure that their end-of-life care is in line with their wishes. Today, we look at how to talk to your loved ones and encourage them to express their wishes so that as they approach the end of their life, you as the caregiver know exactly how to proceed.
Although there are always different techniques for approaching this conversation, there does seem to be one common opinion: the time to do it is now. “Everyone over the age of 18 should have a health care proxy form filled out and should be discussing what they would want done with a person that would be making decisions for them in the event that they are not able to make these decisions for themselves,” said Fern Wasserman, Founder of New York Legal Nurse Consultants. New York Legal Nurse Consultants helps facilitate conversations between the individual filling out their health care proxy form and the people who will need to carry out these wishes in the event this person is unable to make their wishes known.
Colleen Reynolds, President of Edge Communications and former admissions and marketing coordinator of a skilled nursing facility in Fort Myers, Fla., also emphasizes that time is of the essence. “I’d suggest that the Healthcare POA/Surrogate be discussed well in advance of needing it. A DNR should be gently discussed, but discussed again when the decision is imminent,” she said. “I watched so many people struggle with this decision and family members who wished desperately that loved ones asked for a DNR after they had been resuscitated and then left to suffer brain damage and broken ribs.”
In Reynolds’s work, she had to have these conversations with patients who did not have any advance directives on file. “Because the conversations didn’t happen earlier, it was often left up to me to talk to someone who was admitted, if they were not declared legally incompetent, to see if they wanted to be resuscitated in the event of heart failure. Strangers should not have to do this.”
RetireLife Launches Free Prescription Discount Card
RetireLife announces free discount prescription card in partnership with Honest Discounts
RetireLife is pleased to offer ScriptSaveRx, a free discount prescription card that saves card bearers 10 to 60 percent off most brand name and generic prescription medications, accepted at over 60,000 pharmacies nationwide.
The ScriptSaveRx card is great for those who fall in the “coverage gap,” need prescriptions not covered by their health insurance, and those without any insurance coverage! Since there are no age or income restrictions or qualifications, the card can be used by people who would simply like a little extra cash in their back pocket.
The Centers for Disease Control and Prevention estimate that 43.6 million Americans were without health insurance in 2008. Couple this with the fact that $216.7 billion was spent on prescription drugs in 2006, according to The Henry J. Kaiser Family Foundation, Americans can certainly benefit from saving 10 to 60 percent off their prescriptions!
Paying Loved Ones for Caregiving
A benefit established through the Deficit Reduction Act of 2005 can allow family caregivers to get paid for the services they are providing their loved ones, explains today’s article from Home Care Agency News. The Act allocated $1.4 billion to the “Money follows the Person” program. The program allows state programs to allocate the funds directly to Medicaid recipients, rather than nursing homes, and then spend the money hiring the caregiver of their choice, which could include a family member.
According to a study published in 2004 by the National Alliance for Caregiving, 21 percent of the U.S. adult population provides unpaid care to seniors or adults with disabilities, providing an average of 21 hours of care per week – close to the equivalent of a part time, three-shift-per-week job. The “Money follows the Person” program aims to make more room in eldercare facilities by keeping them in their homes for longer with this program.
In addition, Veterans who served during a period of war can recieve the Attendance Pension Benefit, which about 33% of all seniors could qualify for, as long as there is a caregiver contract in place.
To qualify for Medicaid nursing care, cash assets must be spent down to less than $2,000. Many use their cash assets to pay for nursing home care until Medicaid becomes applicable, however, the funds can instead be used to pay a child in return for caregiver services and will still avoid being considered a gift for tax purposes. The Home Care Agency News article advises meeting with an expert in Medicaid benefits to determine the best way to manage the funds you have left in conjunction with planning for when Medicaid will step in.
Readers: What are your experiences with using alternative programs to cover the costs of paying for a caregiver? Were you able to obtain funds to pay a family member for their assistance? Tell us in the comments!
The Risk of CCRCs
A new Government Accountability Office report advises consumers that Continuing-Care Retirement Communities’ (CCRC) high entry cost can also put residents at a high level of financial risk, the Wall Street Journal reports. The average entrance fee for a unit at a CCRC is $249,857, according to the National Investment Center for the Seniors Housing and Care Industry. After this entrance fee, there are also monthly fees that are assessed depending on the level of care a resident needs and the type of contract they have signed. When a resident moves out of a facility or passes away, many contracts will state that they will not be refunded all or part of their entrance fee until after the CCRC has found another tenant.
In addition to the delay in having the entrance fee refunded, patients may find their entrance fee tangled up in bankruptcy proceedings. The Wall Street Journal article links to guides from CARF International (link www.carf.org) and The American Association of Homes and Services for the Aging (link www.aahsa.org). They suggest getting a copy of the facility’s audited financial statements and analyze aspects like the facility’s days of cash on hand and their cash-to-debt ratio.
Readers: Have you or a loved one lived at a CCRC that had financial difficulty, or conversely, was very lucrative? Do you work in a facility in either category? What do you notice about the ones that are successful – are there traits that other CCRCs can learn from?