Caregiver Tip of the Month

When you are a caregiver, you need to know everything possible about your loved one's financial and legal affairs. While this may seem to violate your loved one's privacy – when they were healthy, they may have said that it's nobody's business but their own – this information will help you pay for the care they need, and honor their final wishes. So, in addition to the health and medical information you have already gathered (review it in our May 2004 issue) ...

• Make sure you know their date of birth and Social Security number. You will need this information to access many services.

• Find out if your loved one has the proper legal tools and documents in place. Has someone been appointed to take care of business and make health care decisions in case of temporary or permanent disability? Has he or she made clear their wishes for end-of-life care? If necessary, consult an attorney who specializes in elder law. These are some of the documents you should help the senior prepare if they haven't already done so:

• Will

• Durable power of attorney for finances

• Durable power of attorney for health care

• Living will

• Explore other available financial resources. What assets does your loved one have? Do they own real estate? How much is their home worth? How much is in savings accounts, IRAs, stocks and bonds and other investments? What is his or her monthly income from Social Security, other government programs, private pension plans, CDs, other bank accounts, annuities and investments?

To help you, our sister website, Today's Seniors, has several free booklets where you can write down this information and keep it organized. For details, click on Personal and Financial Organizers.

If you would prefer instead to keep this information online, check out Elder Issues. Their LifeLedger Online Services can give you the information and guidance you need, and the peace of mind you want. For details, click here.

Our visitors ask ...

Q. I'm looking for a cutting board that has some way for vegetables to be held still while my mother slices. She had a stroke, and it affected her right side (she's right-handed). So, she is having to learn to work with her left hand. We need to find her something that a one-handed person can use to cut vegetables. Do you have any ideas?

A. We discussed your mother's situation with several home health care professionals. None of them knows of a cutting board that has a mechanism to hold vegetables for a one-handed person. Rather than using a knife to cut vegetables with just one hand, they recommend using a food processor. It is much safer and easy to use.

Daily Living Solutions

— products for seniors —

As we grow older, it often becomes difficult to use many everyday products because of arthritis and other conditions. If you or a loved one needs a little help – or a lot – we've selected a group of practical and affordable solutions from our affiliated merchants to help overcome those limitations.

Whether you are looking for yourself, or to help an elderly senior continue living in their own home, you'll find a wide variety of supplies and accessories – raised toilet seats, safety rails, incontinence supplies, large-handle eating utensils, pain relief, diabetic supplies, pill splitters and crushers, big-button telephones, canes, walkers, rollators, wheelchairs – and much more.

Everything is sorted into convenient categories in our Solutions for Seniors section.

Caregiving – Finding the money for care at home

In addition to the resources discussed last month (to see last month's issue, click on June 2004), check into the possibility of getting a reverse mortgage on your loved one's home.

A reverse mortgage is a loan against the equity in the home that provides tax-free cash advances to the homeowner, but requires no payments during the term of the loan. The proceeds from a reverse mortgage are available as a lump sum, fixed monthly payments for as long as your loved one lives in the property, a line of credit; or a combination of these options.

These proceeds can be used for anything: daily living expenses; home repairs and home improvements; medical bills and prescription drugs; pay-off of existing debts; education; travel; long-term health care; retirement and estate tax planning; and other needs your loved one may have.

For more information about reverse mortgages, click on AARP's Guide for Consumers.

Caregiver Tip #2

If possible, talk to your senior – include them in the decision-making process – especially when it involves their living arrangements – or their ability to continue driving. Allow them as much independence as circumstances permit. Remember that the caregiver's role is to help them maintain as much control over their lives as feasible, not take it away. This includes allowing them to make their own decisions unless their decisions become harmful to them. The more you can consult with them, consider their desires, and truly respect them, the smoother the transition in your relationship will be.

Helping your loved one retain as much independence as possible will at times be inconvenient for you. But keep things in perspective – when you were growing up, how many times did your parents do things for you, or take you places you wanted to go, regardless of how inconvenient it was to them.

Our visitors ask ...

Q. 4 years ago I relocated to Las Vegas to take care of my mother who is on oxygen 24 hours-a-day 7 days-a-week. She has COPD and Emphysema, and she is being tested for Dementia or Alzheimer's disease. I was wondering if you could direct me in the right direction – the stress I have had with her illness, working full time, starting a small business, I need a week's vacation. Is there an organization out there I could contact to come in and take care of Mom while I take a week to recuperate?

A. What you are looking for is called respite care. Respite, a break for caregivers and families, is a service in which temporary care is provided to a child or adult with disabilities, or chronic or terminal illnesses, and to persons at risk of abuse and neglect. Respite can occur in out-of-home and in-home settings for any length of time, depending on the needs of the family and available resources.

Here are 2 resources that could help. First, call the Eldercare Locator. Developed by the U.S. Administration on Aging, the Eldercare Locator is a free nationwide directory assistance service. It helps older people and their caregivers find local support services to help them live independently in their own community. This information is available only through their toll-free telephone number 1-800-677-1116, between 8AM and 9PM weekdays, Eastern Time.

Second, check out the ARCH National Respite Network's website. Use their National Respite Locator Service to locate respite services. Click on RespiteLocator.org, then click on your state at the bottom of their web page.

Recommended Reading and Videos

Many excellent books and videos can help guide you through the caregiving process. For our recommendations, including a brief description of each one, click here.

Caregiver Reminder

What you need to know when your loved one
is a Medicare hospital patient

If you are looking for assisted living, home health care, skilled nursing or a nursing home, it's usually because of a medical crisis involving a loved one. You're probably in a time crunch – decisions have to be made quickly. The hospital may have said that your loved one will be discharged tomorrow. They've given you a list of rehab facilities, and it's up to you to pick one. But, how do you know which one is best? Are some better than others?

If you are in this situation – take a deep breath – relax a little – and read the next paragraph. You might make a better decision as a result.

Medicare has special rules to keep patients from being discharged from the hospital too soon. In spite of what the hospital may have said, your loved one cannot be discharged until 3 days after the hospital gives you a form called a Notice of Noncoverage. If they have not given you the Notice, insist that they do. (You won't get into trouble by insisting, and neither will your loved one.) This will give you additional time to find the rehab facility that's best for your loved one.

Hospitals discharge their Medicare patients quicker and sicker that ever before. In 1968, patients age 65 and older stayed in the hospital an average of 14.2 days. By 1982, that was down to 10.1 days. Now it only 6.4 days.

Why? Medicare is under constant pressure from Congress to cut expenses. Now, Medicare benefits pay a hospital the same fixed fee for each patient with a particular medical condition – even if one patient's condition is more severe than another's. If a patient stays too long, the hospital has to pay the extra costs out of its own pocket. But, the shorter a patient stays, the more money the hospital gets to keep.

How bad has the situation become? According to The Wall Street Journal, "Nearly one in five people admitted to hospitals with broken hips are discharged before all of their vital signs are stable ... . Those patients are far more likely to die or be readmitted to the hospital within two months."

To protect you, Medicare guarantees you certain rights if you think you are being asked to leave the hospital too soon. Unfortunately, these rights are given to you along with all the other papers a hospital makes you sign when you are admitted. So, they are usually lost in the shuffle, with most people never realizing how important they are. Hospitals sometimes take advantage of that fact. ...

The material on this site is for informational purposes only, and is intended as a supplement, not a substitute for medical advice, diagnosis or treatment provided by a qualified health care provider. More