Home Transitions with Marca Life Planning

Many adults hesitate to make a move when they are faced with the overwhelming prospect of downsizing a lifetime of possessions. At Marca Life Planning, we offer Home Transitions. It consists of several services for you – Retro-Fit, Downsizing, Relocation, and Personal Emergency Response Systems.

Retro-Fit
Most seniors who want to age in their own homes believe they need to change themselves to adapt to their home as they age. In reality, their homes need to adapt to their aging needs. Our Home Transitions program identifies booby traps and obstacles in home safety and provides suggestions to make living easier.

For a one time charge, our CRT specialists visit you at home to discuss aging goals and evaluate the home. Our written Retro-Fit plan provides ideas for aging in place and cost projections through Senior Checked providers. For an additional charge, CRT specialists can help you execute the plan by overseeing your home’s Retro-Fitting process to completion.

Downsizing
When we think of downsizing, we think of moving to a smaller residence. However, a home transition often leads us to reorganize and de-clutter our current living space. A lifetime of collecting memories often results in an excess of objects in our living environment. While these memories are precious, clutter around the home is a hazard and can cause falls and other injuries.

Our certified specialists are trained to help you sort through your items, carefully selecting what to keep that will best preserve your memories, and thoughtfully planning for the gifting and/or sale of the rest.

Relocation
When the home can’t be modified to keep up with aging needs or the home is in a declining neighborhood, relocation may be the best solution.

Relocating is a major life transition and demands physical stamina and time. Whether you’re an older adult or the child of an aging parent, our certified specialists can research the best options for you and provide a written plan to outline your cost. Once you select an option, we provide a single point of contact to coordinate all aspects of the move.

Our job is not finished until the new house feels like home.

Personal Emergency Response Systems
MARCA™ Personal Emergency Response Systems require no monthly or activation fees and allow you to continue an independent life style.

The pendants are splash resistant, so they can be taken into the shower where accidents often occur. Talk directly to family, friends, and an emergency FreedomAlert or Guardian Alert 911 operator at the touch of a button. Communication is through the pendant from anywhere in and around your home.

Ensure a smooth transition and make daily living in your home easy and safe. Contact our specialists at Marca Life Planning about Home Transitions today!


Aiding Elderly Drivers: How to Have the Talk

Experts at AARP stress that every family is different, but it often helps to enlist the entire family to have the talk. According to a survey by the Hartford Financial Services Group and the MIT AgeLab, 50% of married drivers over the age of 50 prefer to hear about driving concerns from (1) their spouses, (2) their doctors, and (3) their adult children.

Safety First
As for the conversation itself, experts say you should approach it from a safety and health perspective, rather than age.

For example, you can say something like, "Does your eyeglass prescription make it tougher to see when you're driving?" or "Does your doctor think your medication will have an effect on your driving?" You can also talk about it in terms of driving itself -- "driving isn't what it used to be" -- focused on the way others drive or difficult road conditions.

If one of their friends has stopped driving, you could also ask, "I hear that Mr. Smith gave up driving. Do you think your driving ability has changed?" or ask about an older family member and when they stopped driving.

Suggest Limits
You can also suggest that your parent puts limits on his or her driving, rather than stopping completely. Ask your parent if he or she might be more comfortable not driving at night, or only in good weather, or just locally and not on highways. These strategies can help you ease them into the idea of hanging up the keys.

Consult a Doctor
If your parent is still unwilling to discuss the matter, you can turn to their doctor -- making it a medical issue and not an age issue. This generation respects their physician's voice and will often take their advice. Older drivers value the opinion of doctors, and some doctors might be able to see if your parent's visual and cognitive skills and reflexes have declined.

Present Alternatives
Many older people reason that hanging up the keys takes away their independence. When you're going to have this conversation, make sure you have some alternatives in mind. Find out if your community has good public transportation that goes where they want to go or an elder organization that offers transportation.

Some will say they can't afford to give up the car and take taxis. Do the math for them, because that might not be true. If they don't have to make car and insurance payments, pay for gas and upkeep, they might find that there's a tidy sum available for alternate transportation.

Suggest They Take a Driver Safety Class or Evaluation
The AARP offers information about driver-safety classes, and a doctor might recommend that your parent undergo an assessment of driving skills, including a road test. The results may surprise your parent so much that they make their own decision to give up driving.


Aiding Elderly Drivers: 10 Warning Signs

Driving is a milestone of freedom in our teen years, but it can become a safety concern when we’re older. Many people don’t spend a lot of time in the passenger seat while their aging parents drive, but that is the best way to gauge their competency.

AARP has created a list of the top 10 warning signs:

• Almost getting into accidents, with frequent “close calls”
• Finding dents and scrapes on the car, or on your parents’ property such as fences, mailboxes, garage doors, or curbs
• Getting lost
• Difficulty seeing or following traffic signals or road signs
Delayed response time such as moving their foot from the gas to brake pedal or confusing the two
Misjudging gaps in traffic
• Experiencing road rage or having other drivers honk at them
• Easily becoming distracted or having difficulty concentrating while driving
Difficulty turning around to check over their shoulder while backing up or changing lanes
• Receiving multiple traffic tickets or warnings from traffic or law enforcement officers

 


Who Needs Long Term Care?

As the population ages and as lifespans increase, the numbers of those needing long term care are sure to rise.

These factors increase one’s risk of needing long term care:

Age: The risk generally increases as one gets older.
Marital status: Single people are more likely to need care from a paid provider.
Gender: Women are at a higher risk than men, primarily because they tend to live longer.
Lifestyle: Poor diet and exercise habits can increase one’s risk.
Health and family history

Other facts and statistics point to the growing need for long term care:

• More than 6 million elderly Americans need assistance from family or friends if they are to live at home.
• At least 2/3 of all home-care assistance is provided free by family members and friends.
• By the year 2020, one of six Americans will be 65 or older.
70% of people turning 65 will need some long term care before they die.
More than 50% of the U.S. population will require some type of long term care during their lives (nursing home care, home health care, assisted living, or rehab facility care).
2021 is the year the oldest baby boomers will turn 75. As the population ages, research has predicted the nursing home population to grow to 3 or 4 million residents.


4 Things Caregivers Wish They’d Known Sooner

Don’t take it personally.
Illnesses such as stroke and Alzheimer’s disease can cause upsetting personality changes. At first, most people think those diagnosed are angry at them but come to realize it is part of physiological changes and an anger at the situation in general.

It’s easy to over-share.
Online “care pages” at sites like caringbridge.org make it simple to update friends and distant family on a loved one’s condition, but you can find yourself getting into details your loved one might prefer to keep private. You can set up different e-mail groups on these pages if you want some messages to go only to caregivers.

Love goes through changes.
If a parent with dementia no longer acts like the person you knew, your feelings are likely to change. This can actually help you cope. Adult children can let go of their parents in small increments as they slowly disappear. The distance acts as a method of self-preservation.

Divvy up the work.
If you’re a hands-on caregiver, your distant siblings can find lots of ways to chip in – especially if you ask. You can also hire a geriatric care manager who will handle a multitude of responsibilities and make the aging process easier on everyone.

By Camille Peri, Reader’s Digest (Dec09/Jan10 issue)


Caring in Tough Times

Looking back, Susan can’t quite remember how she came to be the “designated daughter” for her parent’s care – it all happened so fast. Susan’s father and mother, John and Althea, were happily retired in Maine. But at age 69, three weeks after a checkup concluded with the news that John was in great shape, he had a massive stroke that left him paralyzed on one side.

Althea, who had some medical problems of her own, was quickly overwhelmed. She crashed both of the couple’s cars in a two-month period. By the time an ice storm hit and they were stranded without power, it was clear that something had to change. Fast. “All of a sudden, this charming existence that they had set up for themselves was like a time bomb,” says Susan, 54, who lived in North Carolina with her husband, Gregg, and their sons, then 12 and 8.

“Boom – there they were,” she recalls. “My sister was wheeling Dad off an airplane and I was thinking, Oh, my God.”

Susan set up her parents in an assisted-living residence five minutes from her home. John had always been congenial and capable, mastering everything he set his mind to. Being incapacitated left him depressed. He was not the grandfather her children remembered: He was irritable; they were scared. And his daughter was unprepared for the role reversal that occurs when children are suddenly charged with their parents’ care.

Susan hadn’t anticipated how heavily her parents would rely on her – to take them to doctors’ appts and on outings, to pay their bills and make medical decisions. And she hadn’t realized how quickly the costs would add up. One national survey has shown that caregivers typically spend more than $5000 a year on out-of-pocket expenses. Though Medicare and supplemental insurance covered her father’s medical bills, Susan was the one buying adult diapers, underwear, and other supplies. She can’t even count the number of extra miles she’s put on her car or the unpaid days she’s taken off from work.

Things came to a head seven years into her new role, in the summer of 2005. She was already anxious because her son Robby was by then in the U.S. military, stationed in Iraq. Then her mother got sick and had to be hospitalized. The family dog was diagnosed with cancer. And although her parents had purchased five years of long-term health insurance (“a financial godsend,” Susan says), she discovered that they were running out of money.

The long-term insurance plan had been covering only her father’s medical expenses; after many phone calls, Susan got her mother certified as eligible, too. She was also able to negotiate a lower rate with her parents’ assisted-living residence, in part because they were living in one room. But the whole process, she says, was “excruciating.”

At times, she could barely hold herself together. “Sometimes I thought, Maybe I’ll have a breakdown, and they’ll have to pack me away in a hospital, and I can just get some rest,” she says, laughing. “It sounded kind of appealing, actually.”

It’s been 11 years since Susan began care giving for her parents. Her father has had a seizure and a couple of bad falls. Her mother has been diagnosed with mild dementia. With her sons now in college, Susan works full-time as a teacher’s aide and in a book store during the summer. But her husband lost his job as a general manager of a software company in the economic downturn last December, putting new financial pressure on the couple.

Yet it’s the emotional anxiety that wears her down. “Raising my kids was a snap compared to this,” she says. “Children go through phases, and when you’re in the midst of one that’s not so fun, you think they’ll grow out of it, and sure enough they do. But with my parents, it’s not going to get better.” Still, there are rewards. “I’m trying really hard to do the right thing by my parents, and I guess there’s a certain satisfaction in that,” she says. “And I hope I’m being a role model for my children. At least maybe when their turn comes, they will have a more realistic picture of what to expect than I did.”

By Camille Peri, Reader’s Digest (Dec09/Jan10 issue)


How Do I Find a Care Manager?

Even the Yellow Pages do not cooperate in helping the public find care managers. To find a care manager in your area, look in the Yellow Pages under "senior services."

Below is a partial list of what a care manager might do:

• Assess the level and type of care needed and develop a care plan.
• Take steps to start the care plan and keep it functioning.
• Make sure care is received in a safe and disability friendly environment.
• Resolve family conflicts and other family issues relating to long term care.
• Become an advocate for the care recipient and the family caregiver.
• Manage care for a loved one for out-of-town families.
• Conduct ongoing assessments to monitor and implement changes in care.
• Oversee and direct care provided at home.
Coordinate the efforts of key support systems.
• Provide personal counseling.
• Help with Medicaid qualification and application.
• Arrange for services of legal and financial advisors.
• Manage a conservatorship for a care recipient.
• Provide assistance with placement in assisted living facilities or nursing homes.
Monitor the care of a family member in a nursing home or in assisted living.
• Assist with the monitoring of medications.
• Coordinate medical appointments and medical information.
• Provide transportation to medical appointments.
• Assist families in positive decision making.
• Develop long range plans for older loved ones not needing immediate care.

As you can see, care managers provide an invaluable service allowing you to enjoy and appreciate the twilight years of your loved ones.


What Exactly is a Care Manager?

They go by many names – Geriatric Care manager , Elder Care manager, or Aging Care manager. They represent a growing trend to help full time, employed family caregivers provide care for loved ones living close by or living far away. Care managers are also particularly useful in helping caregivers at home find the right services and cope with their burden.

Services from care managers should be something of which every family takes advantage. In reality, very few families use them. Care managers go a long way toward helping families find better and more efficient ways of providing care for loved ones.

The concept is simple. The family hires a professional adviser to act as a guide through the maze of long-term care services and providers. The care manager has been there many times. The family is experiencing it usually for the first time.

Hiring a care manager should be no different than hiring an attorney to help with legal problems or a CPA to help with tax problems. Most people don't attempt to solve legal problems on their own. The use of professional tax advice can be an invaluable investment. The same is true of using a care manager.

The irony of not using a care manager is that most families, given the opportunity to use the care manager, think they can do it themselves and will not pay the money. Yet the services of a care manager will probably save them considerably more money then doing it yourself. The cost of the care manager might be only a fraction of the savings the care manager could produce. Care manager services can also greatly reduce family and caregiver stress and help eliminate family disputes and disagreements.


When a Loved One Dies: Part Three

LESSON FOUR: Make sure your parents have a person appointed to make financial decisions and health-care decisions for them should they be required. Make sure that they appoint the right person for the right task. A son who is an MD would be good for health-care decisions, but is he too busy to sit by their bedside? Pick someone else who has the time to sit. They can always call Dr. Son who can advise them by phone. With a widow or widower, making plans or changing estate plans is crucial. Make certain that your mom or dad's plans have been updated to reflect the loss of a spouse. And do it quickly. Some spouses don't last too long after they have lost a loved one.

Joe made the decision the day after Jane's death to give away all of Jane's belongings. My wife said that he was angry that she had died and abandoned him and this was his way of showing his anger. In any case, all of her clothes, even her bed, were in the pile to be given away. Joe's daughter was there, and she and my wife went through everything to either keep or give away. They got along well, but not every family is so lucky.

LESSON FIVE: A situation like this could have led to disaster if there was any hostility between the step kids. Ask your parents if they want to cause trouble. If they want to cause friction and drive a wedge between you and your step-parent, all they have to do is nothing. Chances are that upon the first death, the kids and step kids will fight over trivial things and end up hating each other. On the other hand, if your parents want to smooth over issues that could cause problems, deal with their stuff while they still can. Who for example should get the jewelry and the clothes and the shoes and the books and other items of sentimental value? It doesn't have to be in a will, but it does need to be written down.

(From Elder Law Alabama)


When a Loved One Dies: Part Two

LESSON TWO: DNRs should be honored no matter where a patient might end up. If you have one or if your loved one has one, make certain that the document's existence is acknowledged by the staff of the facility where your loved one is residing. Sometimes a simple "DNR on file" note of the chart is sufficient to tip off EMTs that they should ask questions first. And do not confuse a DNR with a Living Will! If confused, ask a lawyer.

Joe had called us when Jane was first admitted to ICU. He was a basket-case and we couldn't get a straight answer from him, partly because of his condition and partly because he didn't know. His generation worships doctors and think they "shouldn't be bothered with questions" or some such nonsense. He was lost metaphorically, and like many guys, wouldn't ask for directions.

LESSON THREE: When in doubt, take charge. My wife and I drove to NC and she took over. Joe was hesitant to call the MDs. My wife got their numbers and called them all to get answers. Joe was hesitant to call his priest. My wife got the priest on the phone and he was there in 15 minutes. Joe was hesitant to ask about the results of tests. My wife got the nurses to chase down the doctors and get answers. So the lesson is this- a grieving spouse is not equipped to handle these matters. He or she needs help but is possibly hesitant to ask for help. Better to ask forgiveness than permission. Take charge but be kind to the spouse and be willing to defer when the situation changes.

Read Bill’s final lessons in our next post...


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