You’re probably hearing more and more about Long-Term Care Insurance, especially if you are a Baby Boomer. It’s important that you learn about all of your options while planning for your future. It’s equally important that you know whether or not your loved one has a policy if you are their caregiver.
Long-Term Care Insurance (LTCI) began in the early 1970’s, following the establishment of Medicare and Medicaid. The original policies covered care only in nursing homes. Over time, policies have evolved to provide easier qualification, payment for more diverse services, and benefits lasting for longer periods of time. Long-term care services are received in a variety of settings, including your home, adult day care programs, assisted living facilities, continuing care retirement communities, Alzheimer’s facilities, hospice facilities and skilled nursing facilities.
You are probably wondering why you would want to buy LTCI.
- Peace of Mind- LTCI can offer affordable protection by covering services to help provide quality care.
- Asset Protection- Retirement funds and life savings can easily diminish due to the high out of pocket cost of nursing homes, assisted living, and even home care. LTCI helps protect you from the need to utilize your assets for care needs.
- Burden- Most people don’t want to burden their spouse or children with the cost of care.
- Choice- With LTCI, you have a choice of care options. With Medicaid, the freedom of choice is lost, along with personal assets.
Who Should Consider Purchasing LTCI?
It’s difficult to predict how much care you will need in the future and whether or not you’ll have family or friends to help with your care needs. There are many factors to consider when looking into LTCI. Some people who might want to consider LTCI are:
- Those with significant assets and income to protect from the costs of long-term care services.
- Those who want to maintain their independence and not have to rely on family or friends for physical or financial support.
- Those who can afford to pay the premiums, even into retirement. Be sure to take into consideration the possibility of premium increases.
Should I wait?
Waiting to purchase LTCI may become an expensive decision. Most people don’t buy LTCI because the don’t understand that importance of planning for their future. Delaying your purchase of LTCI could result in ineligibility to due to health reasons. Some health factors that could deem you uninsurable include:
- Alzheimer’s Disease or other permanent cognitive impairment
- Malignant, inoperable, incurable, recurrent, and metastatic cancers
- Parkinson’s Disease
- HIV or AIDS
- Arthritis- Rheumatoid and osteoarthritis when degenerative or with functional limitations
- ALS (Lou Gehrig’s Disease)
- Strokes and TIAs (“mini strokes”)
- Diabetes with significant insulin use or complications
- Multiple Sclerosis
- Certain eating disorders and severe psychiatric conditions
- Current use of assistive devices- canes, walkers, wheelchairs
- Already receiving care at home, in assisted living, or nursing home
For more information about LTCI, visit:
National Clearing House for Long Term Care Information http://www.longtermcare.gov/LTC/Main_Site/index.aspx
National Association of Insurance Commissioners
Federal Long-Term Care Insurance Program
Home Helpers accepts Long-Term Care Insurance. We work closely with you and your insurance company to help cover some of the costs of home care. For more information about Home Helpers, click HERE.
If you are caring for a loved one with Alzheimer’s or dementia, you may find it increasingly difficult to keep up with their personal hygiene. One of the biggest areas of concern that our clients’ loved ones have is the challenge of bathing.
Jumping in the shower may seem routine to you, but for someone with dementia, the experience can be quite the opposite. It’s very common for people with dementia to forget about, or even lose interest in bathing and changing their clothes. Understanding the cause may better help you determine your approach:
Lack Of Privacy
Many seniors were raised to think that washing and dressing should be intimate, private activities. Some have never dressed or undressed in front of others, which may lead to embarrassment or humiliation. They may refuse to change or bathe in front of others so they can hide incontinence issues.
- Pull down blinds, cover mirrors, and make sure the door is closed for added privacy.
- Approach the person with understanding and reassurance.
- Place a towel over the genitals and simply lift for washing if the person is uncomfortable with nudity.
- After washing, position towels over the person's lap and on the back of the wet shower chair for comfort and dignity.
- Keep them covered while you dress their top half first.
Remember that with dementia, your loved one’s depth perceptions may change, making them feel uncomfortable in small, dark places.
- Make sure that the bathroom is warm, well-lit, and inviting.
- Soft music may help make the environment more relaxing.
- Remove unnecessary clutter. Multiple bottles of shampoos and conditioners may be confusing.
- Keep water at a consistent, comfortable temperature.
- The sensation of water hitting your loved one in the shower may be perceived as painful. Try using a handheld shower wand.
- Spraying the head first can be frightening and cause an aggressive protective response. Start by showering the legs and move upwards to the chest and back.
- Try separating hair washing from bathing. Some people with dementia associate bathing with having their hair washed and become upset because water being poured over their head frightens them.
Remember that your loved one might not bathe as much as you do, nor do they need to. As people age, the body produces less oil, eliminating the need to shower every day. It is important that you do not impose your views about how often your loved one should bathe.
- Try to match your loved one’s bathing routine before the onset of dementia. If they always showered in the evening, set up an evening bathing schedule.
- Consider the time of day when your loved one is most relaxed and not exhausted.
Tasks are too complicated or confusing
Personal care (bathing, dressing, oral care) can be very confusing and complex with all of the steps involved.
- Break down each task into simple steps, while explaining each step. Use simple, respectful language.
- Try offering the person limited choices.
- Let your loved one feel the water before getting into the shower. Saying things like “The water feels nice” or “This feels so good”, can be reassuring and calming.
- Encourage your loved one to do as much as possible.
- Lay out the soap, washcloth, towel and clean clothes in a sequence so your loved one can use them as needed.
Always remember that patience is key. If your loved one shows signs of agitation, take some time to step back and regroup. Move onto another activity for a few minutes, then try again. If all else fails, sponge baths can be an option.
For help and information, contact the Alzheimer’s Association.
Home Helpers’ caregivers are trained and experience with Alzheimer’s and dementia. If you feel that you can no longer care for your loved one on your own, click HERE to learn how we can help.
While most of us have probably lost our keys or misplaced something that was under our nose the whole time, a question many people have is, “Is there a reason to be concerned, or might it just be a Senior Moment?”
A challenge for many families is often determining at what point a change in behavior merits consideration, and when to pursue medical attention.
People often make statements such as “Dad’s going nuts,” or “Mom’s lost her mind,” and don’t recognize that treatments may be available to help a loved one. Dementia, depression and delirium are conditions that cause behavior changes, yet are often undiagnosed and untreated.
The incidence of all three conditions increase as people age. If you sense a change in a loved one’s behavior, encourage your loved one to undergo an assessment by his or her physician. To help health care professionals diagnose and treat a medical condition, it can be helpful to keep a journal of unusual behaviors and report any and all symptoms.
Let’s take a look at each of the three conditions:
DEMENTIA is a term that describes disorders that affect the functioning of one’s brain, and it is characterized by mental decline and impairment. Dementia and Alzheimer’s, a degenerative disorder of the brain, is reported to be the most common cause of dementia in older adults. The Alzheimer’s Association reports that “As many as 10% of all people 65 years of age and older have Alzheimer’s. As many as 50% of all people 85 and older have the disease.”
People with Alzheimer’s have dementia; however people with dementia don’t necessarily have Alzheimer’s. For example, people with chronic conditions such as Parkinson’s can have dementia. A common form of dementia is a condition referred to as Multi-Infarct, where blood flow is cut off from a certain part of the brain, resulting in permanent damage and loss of mental capacity.
People with dementia often have trouble with their ability to recall information, solve problems and speak. They may also act strange or seem moody. People with dementia often lose the ability to perform everyday tasks necessary to live independently. Another characteristic is an inability to make decisions or respond to questions.
DEPRESSION refers to a mood disorder that can affect both a person’s mind and body. While many people never seek treatment for depression, those who do often experience improvement over time. While everyone occasionally feels depressed or sad, depression is characterized by intense sadness that lasts for a period of two weeks or longer, and impacts a person’s ability to lead a normal life.
DELIRIUM is a cognitive or mental disorder, not a disease. Delirium appears suddenly, often within hours or days, and may come and go throughout the day. A person who is delirious may appear disoriented, exhibit varying levels of consciousness, have disorganized speech, and an inability to comprehend what’s being sad. Delirium can be frightening as a loved one acts unpredictably, is uncooperative and sometimes acts violently. With delirium, there is typically an underlying cause such as infection (commonly UTI’s in older adults), dehydration, physical illness, head injury, trauma, substance abuse, or a reaction to medications (e.g., prescription, over-the-counter, supplements). Once the cause is identified and treatment begins (e.g., changing medications, increasing fluids or treating infections), there is often a quick turn-around.
SEEK MEDICAL ATTENTION
If you notice a change in a loved one’s behavior, regardless if the change is sudden or gradual over time, seek medical attention. Health care professionals are likely to complete an assessment to rule out possible causes, make a diagnosis and determine treatment options. People who receive treatment often enjoy a better quality of life.
Your loved one was recently diagnosed with Alzheimer’s disease and you’re probably wondering what you’re supposed to do now.
It’s important to take some time to digest the information. Understand that your loved one’s Alzheimer’s may progress slowly, over time. You may have many good years ahead with your loved one. Take time to discuss what you both want to do to enjoy the time that you have together.
After you’ve had time to come to terms with the diagnosis, it’s important to consider the following:
- How will relationships change with family, friends, and co-workers?
- How is your loved one coping with memory loss and changes?
- What is the impact of the diagnosis on your loved one’s career, family role, social engagement and/or finances?
- What is the impact of the diagnosis on your loved one’s ability to drive?
- What is the impact of the diagnosis on your loved one’s ability to work?
Do’s & Don’ts:
Allow your loved one time to share his/her feelings/thoughts
Assume that your loved one is incapable of making decisions
Assume that your loved one will remember what you have discussed
Use reflective listening
Move immediately into problem solving
Use a soothing tone of voice
Do not jump into conclusions
Ask questions to explore your loved one’s concerns
Do not say, “Don’t cry” “It can’t be that bad” “It will work out
Treat your loved one as an independent, viable person
Talk to your loved one as if they are incapable of understanding
Talk slowly and clearly –giving your loved one time to process information
Talk quickly or jump from one subject/question to another
Allow time for responding to questions
Fill in words or finish their thoughts
Allow time for telling friends and family
Force your loved one to tell people about the new diagnosis unless they are comfortable with it
Look into support groups
Assume that their progression will be the same as others
One of the best things you can do for you and your family is to get legal, financial and care plans in place. Doing so allows you to participate in making decisions and ensures your family won't be forced to make them for you in a crisis situation.
Plan for the future now!
For more information, visit the Alzheimer’s Association.
Click HERE for more information about Home Helpers.
According to the Alzheimer’s Association, 6 out of 10 people with Alzheimer’s disease will wander. As a caregiver, you may have experienced your loved one wondering away from you. Many people with Alzheimer’s disease wander from their caregiver or even their own home. You need to know how to prevent your loved one from wandering, as it may have dangerous and life threatening consequences. By following some important tips, you will help keep your loved one safe and give yourself peace of mind.
- Make sure that your loved one has some kind of identification on them at all times. The Alzheimer’s Association offers MedicAlert® + Safe Return®, which is a 24-hour nationwide emergency response service for individuals with Alzheimer’s or a related dementia who wander or have a medical emergency. For more information, visit www.alz.org/safereturn or call 1-888-572-8566
- Make neighbors and local police aware that your loved one with Alzheimer’s disease wanders.
- Keep an updated picture of your loved one. Police will need to know what your loved one looks like if they are lost. Out of date driver’s license pictures may not be enough.
- Install door chimes on all doors that lead to an exit. This way, you’ll hear if your loved one leaves the house.
- Consider camouflaging doors. To short-circuit a compulsion to wander into off-limit rooms, you might place curtains over doors or camouflage doors with paint or wallpaper that matches the surrounding walls. A mirror or a stop sign on the door might help, too.
- Plan activities and distractions. If you notice that your loved one wanders at certain times of the day, plan activities around those times. It can be as simple as looking through old pictures, getting them involved with the laundry, or having a snack with them.
People who have Alzheimer's often forget where they are, even inside their own homes. It might help to post descriptive photos on the doors to various rooms, such as the bathroom, bedroom and kitchen. Hang a picture of your loved one on their bedroom door so they that it’s their room.
It only takes a moment for someone to wander away. Even the most diligent caregiver has to sleep, bathe, or talk on the phone. It’s vital that you arm yourself with wandering precautions. 93% of Alzheimer’s patients who wander and are found within 12 hours survive. Seven percent don't. About one in 14 don't make it home alive. Of those lost more than 24 hours, only a third survive. Of those lost more than 72 hours, only 20 percent survive.
For more information about the Alzheimer’s Association, click HERE.
For more information about Home Helpers, click HERE.
Dr. Beverly Jones always dispenses this advice to the Alzheimer's caregivers who come through his office: You will never win an argument with an Alzheimer's patient.
"Family members simply cannot recognize how severe the memory loss is," he said. "They see the same person on the outside and just can't comprehend how different they are on the inside."
Winston-Salem doctors specializing in geriatrics and other seniors advocates shared their tips on living day to day with an Alzheimer's patient.
•Set up a no-argue zone. "If you argue with a person with dementia, both people just end up upset, and nothing is accomplished," said Dr. Kaycee Sink, director of the Kulynych Memory Assessment Clinic at Wake Forest University Baptist Medical Center. "With dementia, logic and reasoning are failing, and the person with dementia truly believes that the way they think is correct. If it's a minor issue, just concede. Put on your turtle shell and just let it slide off your back."
•Keep communication short and direct. "If a certain attempt is not working, come back to it later, maybe another way," Jones said. "You must pick your battles, and you must be flexible as a caregiver."
•Don't correct everything, especially if it's inconsequential. "If you try to make a point, it doesn't matter, because two minutes down the road, she won't remember it anyway," said Scott Trotter of Winston-Salem, who takes care of his mother. (See story on previous page .)
But what if the things the Alzheimer's patient says really are untrue and are harmful? One Alzheimer's patient, for example, told everyone she met that her daughter was spreading lies about her.
"You may never be able to convince her of the truth," Sink said. "In this case, for example, the daughter might have to make phone calls privately to the people her mother has spoken to and say, 'This really didn't happen.' But mostly, the people already know that the mother has problems."
•Don't take away what the Alzheimer's patient can do. Pick an activity that is appropriate to the person's level. If she can't cook an entire meal, perhaps she can slice the tomato for the salad.
"Allow them to do as much as possible, even if it's not up to standard," Sink said.
•Do things on a schedule as much as possible, Trotter said. This usually means less hassle.
•Always sit and listen, no matter what the loved one is talking about. Don't say you don't understand what they are saying. "The few times I caught myself saying 'I don't understand,' that would just frustrate her more or make her angry," Trotter said.
•Don't let the person see you get upset. Hide it and vent later with a friend or loved one, Trotter said.
•Don't treat the person like a child, even if some behaviors are childlike.
•Don't push someone to do things he cannot, such as a crossword puzzle that is too difficult.
•If a person with dementia is upset, try to get at the underlying emotion, Sink said.
For example, one man with Alzheimer's routinely worried that his money was going to run out and that he would be left poor. His daughter kept his bank statements nearby, showing them to him again and again. "Look Daddy, here's your money, safe and sound," she would say, and each time he would relax a bit.
Sometimes it almost takes stumbling upon the right words to calm an Alzheimer's patient. Sink told the story of one woman with dementia who worried constantly about her parents, who had long since died. She shouted out again and again, "Where's my mother and father?"
Various people told her, "They are coming for you," but then the woman became worried that her parents were lost.
Finally, someone told her: "Well, I don't know where they are, but they know where you are. And they love you very much." This satisfied and relaxed the woman, at least for a while, Sink said.
•Perhaps most important: Caregivers must give themselves a break.
"Build in some support for yourself, in terms of people who can help," Jones said.
The community offers adult day programs; take advantage of them, he said.
"The biggest problem I see is that caregivers work themselves to death," Jones said. "Literally. I have seen some caregivers who died before the Alzheimer's patient did. Lower your expectations and take it day by day."
For this new decade, caregivers looking after someone with dementia are better off focusing on tasks that will help them power through another demanding year.
The following resolutions may be unexpected, but they're heartfelt and truly helpful:
1. I will order my priorities so that I come first.
Selfish? More like practical common sense, because if you fall apart physically or emotionally, you put the welfare of those you care for in jeopardy.
2. I won't beat myself up if I lose my patience.
Because you know you will. (Both lose your patience and berate yourself for it.) Dementia care can be immensely frustrating. You wouldn't be human if you didn't vent. Try to mostly vent to others with well-functioning brains (or to a pillow or a workout), but cut yourself slack if you occasionally bloop and take it out on the person with dementia.
3. I will spend less time chasing cures and more time embracing today's "new normal."
Obviously you want to practice some of the many ways how to slow the progress of Alzheimer's disease. But don't get stuck in "battle mode" when there's no cure; better to reserve your energy for maximizing the quality of each day, which may not be like the day before.
4. I won't sweat the medium stuff.
If you've dealt with dementia for any length of time, you probably don't sweat the small glitches of life much anymore (keys in the trash, repetitive stories). Now add even bigger things to the list of things you'll be impervious to –- so long as nobody's in danger, it's amazing what can be "okay."
5. I will read something that lets me wallow in my sadness a little.
Escapism has its plusses, but so does insight. And there's a title for nearly every circumstance. Three great recent choices: Mother in the Middle by Sybil Lockhart (a neurobiologist is pregnant when her mom is diagnosed with Alzheimer's); I (Still) Do: Loving and Living With Alzheimer's by Judith Fox (a photographer about her husband); Pig Candy: Taking My Father South, Taking My Father Home by Lise Funderburg (making a dying dad's wishes come true).
6. I won't force.
Here's one that makes things easier for you. When you get to that point where you're exerting excessive energy trying to make something happen, step back. It's probably not worth it, whether you've been forcing someone to take a pill, forcing him or her to get in the car, or forcing some personal matter. Reassess whether it really matters. Drop it. Try later.
7. I will eat more chocolate.
Call it a corollary to #1. Make it dark and keep the portion moderate, and you can keep this resolution every single day. Katherine Hepburn reportedly did – no cost to her waist, big boost to her mood.
8. I will stay engaged even if I get very little back – because I am getting something back.
I'll tell my loved one about my day even though he or she is unresponsive. I'll touch my loved one even if he or she never reaches for me. I'll smile even though my loved one frowns. Thing is, these actions do more than benefit the person with dementia. You, too, get a stress-dropping payoff from reaching out – a bonus of being human.
9. I won't forget the saying, "There but for the grace of God go I."
Good for helping you bite your tongue the 51st time you're asked (in 60 minutes), "What time is it?"
10. I will do what I can to protect my own brain health.
You have a front-row view on the toll dementia can take. Make that -– not thinner thighs or fewer wrinkles –- be your incentive for taking charge of your health as best you can this new year and new decade.
The holidays are a time when family and friends come together and share memories, laughs and good cheer. But for families living with Alzheimer's, the holidays can also be a difficult time.
Caregiving responsibilities layered on top of keeping up with holiday traditions can take its toll on Alzheimer families, especially the caregiver. The person with Alzheimer's may also feel a sense of loss during the holidays.
With some planning and adjusted expectations, your celebrations can be filled with joy and magical moments to cherish forever.
Adjust your expectations
No one, including yourself, should expect you to maintain every holiday tradition or event.
- Give yourself permission to do only what you can reasonably manage
- Choose holiday activities and traditions that are most important to you
- Host a small family dinner instead of a throwing a big holiday party
- Consider serving a catered or takeout holiday meal. Many grocery stores and restaurants offer meals to go.
- Start a new tradition. Have a potluck dinner where family or friends each bring a dish
Involve the person in the festivities
There are many manageable activities the person and you can do together, such as:
- Wrap gifts
- Bake favorite holiday recipes together. The person can stir batter or decorate cookies.
- Set the table. Avoid centerpieces with candles and artificial fruits and berries that could be mistaken for edible snacks.
- Talk about events to include in a holiday letter
- Prepare simple foods such as appetizers
- Read cards you receive together
- Look through photo albums or scrapbooks. Reminisce about people in the pictures and past events.
- Watch a favorite holiday movie
- Sing favorite carols or read biblical passages
When the person lives in a care facility
A holiday is still a holiday whether it is celebrated at home or at a care facility. Here are some ways to celebrate together:
- Consider joining your loved one in any facility-planned holiday activities
- Bring a favorite holiday food to share
- Sing holiday songs. Ask if other residents can join in.
- Read a favorite holiday story or poem out loud
Courtesy of The Alzheimer's Association
(Source: The Alzheimer's Store) - As family and friends immerse themselves in the holiday spirit one seemingly insurmountable challenge is the annual dilemma of what to buy someone who themselves are immersed in a disease. But the answer really is simple and it differs little from the principles that apply to everyone - a gift that generales a smile.
There are three keywords regarding gifts for people with dementia: familiarity, "old faithful" and success.
- Familiarity - For someone with Alzheimer's or other form of dementia, a gift that is already familiar to them requires little explanation and is always accompanied by long term memories. This alone is a formula for success.
- "Old Faithful" suggests that if it worked before, it will work again, i.e., if Mom liked the red sweater last year, then she'll probably like it again this year. The seemingly inappropriateness that you are repeating the gift may no longer apply (or find one that is slightly different).
- Success refers to the fact that with this disease, success is a rarely achieved feeling, so simple, easy-to-understand games and products bring success much closer - for both the gift recipient and the gift-giver.
If you can find a present that shares all three of these characteristics, you've hit the ball out of the park. Keep in mind also, that everyone is different and people may be in different stages of the disease. But there's one more ingredient, that only you are the expert in, that is - knowing your loved one and what works best for them.
Here are a few gift suggestions:
- Simple Puzzles - For the puzzle lover who may no longer be able to assemble the 1000 piece puzzle, consider a puzzle of fewer pieces, such as 12 or 24.
- Warm Clothing for Chilly Days and Nights - People in the later stages of dementia may no longer be able to communicate discomfort, though they may feel the cold just as much as you or me. Plus, older skin thins as we age and the insulating layers of fatty tissue beneath diminish. Look for light-weight, fashionable warm materials that are as pretty (or handsome) as they are functional.
- Hobby-related Gifts - For the man who always toyed with projects in the workshop then something as simple as a tool box is a sure and practical winner. For most, this gift is an item of pride, familiarity and function.
- Gifts That Solve a Problem - For many with dementia, the TV remote is as much an obstacle to watching TV as finding a good show to watch, despite the 300 channels we have to choose from. All the extra buttons - for video, DVD, etc. - are very confusing. But there are remotes that offer only a few buttons - for volume, on-ff and channel selection only.
- Calming Comfort - Though it may be hard for many of us to fathom, people with Alzheimer's regress, that is, as they lose their short- and mid-term memory (leaving only their long term memory). To us on the outside, they seem to move backwards in time. What is most familiar and comforting to them are now items that generated those feelings many years ago, perhaps even when they were children. As such, soft, tactile stuffed animals and dolls once again offer the warmth and comfort they did once before. They require no explanation, they do so much and they certainly generate smiles.
People who consume foods rich in vitamin B12 could be at lower risk of developing Alzheimer's disease.
Researchers analyzed blood samples from more than 270 individuals who showed no evidence of dementia. They tested for levels of vitamin B12 and for levels of homocysteine, an amino acid that has been linked to an increased risk of Alzheimer's disease, and then tracked the study participants for seven years.
Each unit increase in vitamin B12 reduced the risk of developing Alzheimer's by 2 percent.
According to CNN:
"The relationship between vitamin B12 and Alzheimer's risk is 'complex' ... B12 levels, particularly holotranscobalamin levels, likely play a contributory role."