Nursing Home Residents in Smaller Numbers but Sicker

A new study completed by Kaiser identifies what many operators in the nursing home industry already know.

As residents’ conditions are getting worse, occupancy levels are decreasing. Investigators recently identified that half of the nation’s nursing home residents had a dementia diagnosis and approximately two thirds of residents were currently receiving psychoactive medications such as anti-anxiety drugs, antidepressants or antipsychotics.

Just under a third of current nursing home residents have a psychiatric condition. The total nursing hours increased per resident for each day to 4.1 throughout 2016.

Other findings from the Kaiser study are that a proportion of for-profit-facilities has increased to 69% in 2016 and that Medicaid remains the primary payer for most of these facilities.

If you are contemplating long term Medicaid planning, it essential to consult with an experienced estate planning attorney to help you accomplish these goals and determine your next steps. Protecting a loved one’s interest is imperative and it is necessary to complete a thorough review of proper Medicaid planning to figure out how these facilities will be paid for.

The Quality of Nursing Facilities Could Impact Long-Term Care Transitions

Many people who are interested in learning about protecting their long-term care opportunities in the future are primarily concerned about the best way to protect their individual assets and to ultimately qualify for Medicaid. These are complicated issues that are often addressed in the Medicaid planning process with the help and support of a knowledgeable estate planning attorney.

A recent study published in the Journal of the American Geriatrics Society identified that the quality of a nursing home can be extremely important for the outcomes for the patients inside. For example, those patients who were placed inside nursing homes that tended to have higher quality ratings overall had a much lower chance of being transitioned to a long-term care facility over time. It turns out that interventions with these people earlier on in their initial medical condition screening could help to decrease the person’s chances of being transferred to a longer-term facility to continue the management of these needs.

If you are curious about how to pay for long-term care and recognize that this may be an important part of your future, it may be beneficial to schedule a consultation with an experienced estate planning and long-term care lawyer today.

Tips for Avoiding Social Isolation with Seniors

Whether you’re an adult child concerned about an aging parent or growing concerned about your own social isolation, recognizing the signs and symptoms is often the first step to be taken to protect yourself.

Sadly, isolation for senior citizens is a relatively common issue. It’s something that family members and the senior should pay attention to. Family members can play a crucial role in supporting an elderly loved one by being aware of the risks and signals of isolation and by stepping in to help with transportation.

Here are several tips that can help avoid social isolation:

  • Make sure that a loved one who has maintained church attendance continues to do so by identifying carpool opportunities or making other transportation available
  • Keep neighbors in the loop for regular check-ins and encourage weekly or regular social gatherings or meals.
  • Attend regular vision and hearing tests, as many seniors may be avoiding social interaction due to embarrassment about being able to see or hear properly. Making these tests easily accessible with transportation can be very helpful for a loved one.
  • Plan regular family interactions that include the elderly loved one. A weekly check-in or Sunday night dinner can give a senior something to look forward to and it’s a chance for family members to monitor health and nutrition issues in the elderly loved one.

Social isolation, when ignored, could lead to anxiety and depression. It can also amplify the impacts of cognitive and other healthcare issues.

If you’re concerned about an elderly loved one and want to ensure that he or she has properly planned for the future, consult with an experienced elder law attorney.

Your area Council on Aging might also offer programs to assist with these issues and some even offer free or reduced transportation. The following resources may be a great place to start:

Arlington

Woburn

Winchester

One Hundred and Happier Than Ever

She’s never been in a nursing home. She lives alone, takes care of herself, and appears to be in perfect health. She’s the envy of many — thriving, highly respected, and seemingly happy as can be.

She’s Ann Husfloen of Wisconsin, and she is 100 years old.

I recently came across a news article about Husfloen’s one-hundredth birthday party (apparently something of a town-wide affair), and her high spirits and great health made an impression on me. After all, most people her age utilize some kind of assisted living service, and most can’t quite claim picture-perfect health.

But there is Ann Husfloen, looking radiant and not a day over 70 in her newspaper profile. She’s living like most twenty-year-olds… by herself and playing cards with the neighbors at night for fun now and then.

Interesting, when she was in her twenties, she got a job as an assistant care provider for ailing elderly women in her area. Maybe that experience helped her approach old age with the grace that now earns her the neighborhood’s admiration. She is “such a lady,” her property manager says.

Of course, things aren’t exactly the same as they were eighty years ago. She doesn’t drive anymore (she gave that up at age 93!), and she does have some help cleaning the house for a couple of hours each day. Otherwise, she isn’t anyone’s idea of what 100 looks like.

Maybe Ms. Husfloen is the face of the future, though. With new advances in medical science and an ever-expanding average lifespan, it’s likely that more Americans will reach age 100 in the decades ahead.
Naturally, most of us will need a little more help along the way. The challenge for now is keeping ourselves healthy, embracing a positive attitude in the face of growing older, and making financial arrangements to provide for what might be a very long life.

That last goal is a big part of what I help people with as a Middlesex County elder law attorney. If you were as touched by Ann’s story as I was, give my office a call and we can talk about practical ways to secure a bright future for you too. I’d love to help.

Wine & Dine at Age 89? Why Not?

The assisted living industry is out to make a new name for itself, or at least certain parts of it are. As seniors live longer lives, they’re increasingly interested in finding better places to enjoy their time. For many, the conventional nursing home just doesn’t cut it, and the market is becoming ever more aware of that fact.

I recently came across an English-language article in a Finnish newspaper, and it reveals some of the fascinating new developments in Finland’s senior care.

A slew of new retirement homes are opening there, each designed to cater to popular pastimes or specific hobbies. One home emphasizes gardening, for instance, and its residents spend much of their day outdoors. Others, meanwhile, focus on providing fancy four-course dinners and excellent glasses of wine every night.

There are even “old-age homes,” as they call them, that specialize in environmentalism, cultural media, and sports! Those options have apparently proven quite popular there, though the more diverse selections are largely confined to Helsinki and other big cities.

Cost is a major concern, too. Even by-the-book senior care is expensive, so more specialized services like these come with a considerable upcharge. That makes them an option only for the wealthy or those who’ve planned prudently and well in advance.

Stateside, we’ve started to see specialization and innovation in our own senior care industry as well, though perhaps not yet quite so creative as the Finns. As the pendulum continues to swing in that direction, we’ll probably see much more specialization in the years to come. Of course, cost will be an all-important factor for America’s seniors, too.

If you’re peering down the road into your own future and think that a different kind of “old-age home” might be right for you, the time to start planning is now. One of my primary focuses is helping people employ sensible strategies for saving and utilizing all the available resources out there to secure their futures in advance. Give me a call to talk about what we can do together.

Nursing Homes Replacing Hospitals for Primary Senior Care

We always hear about the rising number of Americans who turn to hospitals (particularly Emergency Rooms) as their primary source of healthcare. Likewise, we hear a lot about the constantly rising costs of nursing homes in America — especially here in Massachusetts and throughout New England.

I was struck, then, by a recent New York Times article that makes a surprising report: senior citizens are increasingly less reliant on hospitals for healthcare, as nursing homes are able to step up to the plate in their place.

Why the shift? Here are a few factors:

  • Healthcare Mobility — As the Times notes, many complex procedures like blood transfusions used to require several days spent in an outpatient hospital wing. These days, those same procedures can practically be done on the go. Nursing homes can give their residents a quick lift to a nearby medical center for a transfusion in a matter of hours. All of the follow-up care, including IV therapy, can be done back in the resident’s own room.
  • Risk of Injury and Infection— Despite popular belief, the hospital isn’t the safest place for the elderly. Falls, bedsores, depression, and hospital-acquired infections are all dangerous and increasingly common risks of any hospital stay. While those perils are present in nursing homes too, the rates of occurrence tend to be a little lower there.
  • Costs — Nursing homes are extremely expensive, but so are hospitals. Regularly relying on hospital clinics or Emergency Rooms can prove even more financially taxing than the monthly nursing home bill. That fact has insurance companies, Medicare, and Medicaid urging nursing homes to ramp up their roster of hospital-like services.

Of course, there’s still a lot of work to be done. Amazingly, many of today’s nursing homes still don’t staff registered nurses 24/7, and not all homes offer the same easy access to nearby outpatient clinics.

It is encouraging to know, though, that alternative approaches to senior care are developing quickly. Within the next few years, we may see seniors spend less and less time in hospitals, and that should hopefully translate to financial savings, fewer infections, and a lower rate of hospital-related injury.

Naturally, though, paying for nursing home care remains a real challenge, regardless of how much additional time gets spent in a hospital. Fortunately, proactive planning can make those costs much more manageable. To that end, my office can be of some help. Give me a call today to talk about setting up a plan that makes sense for you.

What Senior Care Looked Like Sixty Years Ago

Nearly 60 years ago, in 1959, LIFE magazine ran a four-part photo essay that spawned national outrage and spurred the country toward change. Billed as a real-life kind of horror show, the magazine captured in stunning detail the harrowing experience of America’s senior citizens.

This was before Medicare, before Medicaid, before our modern medical advances, and just a couple of decades into Social Security. If the elderly are still fighting for visibility in today’s society, they were all but veiled then. Most Americans were blissfully unaware of the typical conditions in a senior care facility, which were far worse than the still-lacking nursing homes we know today.

Shot in haunting black and white, the pictures shook readers to their cores. There was nothing especially graphic or grotesque in them, but the stifling unhappiness of these people’s lives was nearly tangible. LIFE challenged readers to picture their own parents or grandparents “stored away like vegetables,” reminding the young that a similar fate awaited them, too.

Then the editors went beyond merely showcasing the problem. They called for action and solutions. Looking back, we might consider it one of the many impetuses for Medicare and Medicaid. Indeed, in a new retrospective on the original photo essay, TIME/LIFE credits Medicare with much of the change we’ve seen since then.

Unfortunately, Medicare and Medicaid still don’t solve all of senior’s problems, and securing their benefits can prove entirely too difficult. In my office, I work with the elderly and their families every day to ensure that their own senior-care experience paints a much better picture. With the right strategies and plans in place, there is no reason that today’s elderly can’t enjoy extremely happy and fulfilling lives throughout old age.

If you’d like to look back into the past, you can view many of the 1959 photos on the TIME/LIFE website. Meanwhile, if you’d like some help with your own senior care planning here in the present day, please feel free to give me a call. I’m here to help.

Is the Green House the New Nursing Home?

Every so often, cultural institutions give way to paradigm shifts. That might be the case with the conventional nursing home, according to a new report from The New York Times.

In today’s society, when parents age and become less self-reliant, they generally have three options: live with children or other close family members, hire in-home care, or move into a nursing home.

It’s not always a choice between the three, though. Living with family requires relatives with sufficient time and space for providing attendant care. In-home assistance, meanwhile, is extremely expensive — especially if it has to be around the clock.

So without adequate resources, many elderly people resign to the nursing home by default.

That isn’t always a bad thing. Some nursing home experiences prove to be happy and effective ones for their residents. But, as the Times argues, many would rather live somewhere else if given the chance.

As I mentioned earlier, though, paradigms change. Increasingly, seniors aren’t resigned to just the three conventional choices anymore. A variety of innovative approaches to senior living are diversifying the elder care marketplace.

One promising example is the Green House Project, a new kind of living environment for older Americans, already available in more than half the country. (There are currently two locations in Massachusetts — Westwood and Chelsea).

Green House residents live in pleasant cottages with their own private rooms and baths. The idea is to create a community in which seniors help take care of themselves and each other.

For example, those who’re able can help prepare the Green House meals, which are served in an inviting dining room rather than a stifling cafeteria. Residents schedule their own mealtimes and generally enjoy greater autonomy than they might have in a nursing home.

The Times talks about the project as a potential catalyst for industry-wide change. That’s an inspiring thought, especially when you consider that a variety of other nursing home alternatives are flourishing throughout the country at the same time.

Things keep looking up for the future of senior care in America, and I can’t wait to see what comes next.

When Your Parents Lose Their Independence

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Moving is always a stressful experience. But for an elderly person who may be forced to give up his or her home — and possibly independence — it can be downright traumatic.

However, an article I read last week in the Wall Street Journal on line offered some tips on how the transition can be eased.

The most important, the article said, is to offer the older folks the opportunity to make their own choices, if possible. The earlier planning is started, the better.

Starting the discussion early allows for all options to be considered.

Of course, many older folks will not want to have that discussion, but it is important to remind them that if the time comes when they cannot make their own decisions, they will have to be made for them. This way, they get to choose.

If assisted living is in the picture, the adult children should do the research and present the options to their parents. They should be given the chance to visit the various facilities and, once a decision is made, should be given the opportunity to decide what personal possessions they want to bring with them. Many facilities will have floor plans available so the furniture layout can be finalized weeks in advance.

Make sure to get the new residence set up, and the personal items unpacked before your parents spend their first night there. Check with the on-site case managers to see if the adult children should spend a lot of time there in the first few weeks. Some facilities have advised that the children not spend too much time with their parents because it gives the parent a chance to get adjusted on their own.

At the same time, you cannot neglect your own families and duties.

Moving parents can be a challenge, but, done right, it can be done well.

Rules Governing Care Of Dementia Patients In Massachusetts Amended

Workers in nursing home dementia care units will now have to receive eight hours of initial training plus four hours of additional training every year, according to rules recently adopted by state regulators. The new regulations also require such facilities to have, at the very least, one therapeutic activities director. The therapeutic activities director is responsible for ensuring residents in the dementia unit are provided with appropriate and meaningful activities.

Dad at Diamond Ridge Healthcare Center (Novemb...

(Photo credit: cseeman)

These new regulations close a legal loophole that permitted nursing homes to advertise their dementia units without actually providing workers with specific training or residents with specialized activities. The regulations were finalized by the Public Health Council, an appointed body of health advocates and academics that sets public policy.

Another change that has been under discussion of late is the requirement for a 6-foot fence surrounding outdoor areas, with the goal of preventing residents from wandering away and becoming lost.

However, some nursing home operators objected to this change, arguing that facilities in urban areas might never be able to meet a requirement mandating that residents have access to outdoor space if 6-foot fences were required. Other operators said that fences this high could reduce residents’ enjoyment of the opportunity to be outside in the first place.

The Public Health Council came up with a compromise, requiring that nursing homes with dementia care units must have a “fence or barrier to prevent injury and elopement.”

It is important to note that the new regulations require that all licensed nursing homes, not simply those advertising dementia units, must provide dementia-specific training for every direct-care worker within 180 days.

As a dedicated Massachusetts elder law attorney, I applaud these new regulations and invite you to click on the link below to learn more about them.

http://www.bostonglobe.com/lifestyle/health-wellness/2014/02/13/dementia-care-rules-finalized-for-massachusetts-nursing-homes/ruU64q0mgJ4Db7dVegROyK/story.html

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