Seniors Need Protection from Nursing Home Abuse

It’s a story I hate to write or even read, but sticking my head in the sand will not make the problem go away. And because June 15 was World Elder Abuse Awareness Day (WEAAD), I thought it would make sense to talk about the issue today.

Elder abuse takes many forms; physical, emotional, sexual and financial abuse unfortunately affects hundreds of thousands of seniors each year. Nursing home residents are especially vulnerable.

Back in February 2014, a Bronx New York nursing home employee was charged with raping an elderly resident who is unable to communicate. Manhattanville Health Care Center LLC had a Medicare overall rating of 5 stars, whereas, because of its number of reported bedsores and its low C.N.A.-staff-to-resident ratio, the facility’s Caregiverlist’s® Nursing Home Star Rating was a mere 3 stars.

Recently, a Florida nursing home CNA's father received a 7-year sentence in an identity theft case, where he used stolen identification information to file fake tax returns and get refunds, according to an article in McKinght Long Term Care News. Palm Garden in Polk County, Florida, also received only a 3-star Caregiverlist® Nursing Home Rating.

An evaluation published in the Journal of Elder Abuse and neglect details a seven state Criminal History Screening (CHS) program for long-term care workers. The report states that popular support for enhanced criminal history screening (CHS) procedures for long-term care workers in the United States is evident; case studies and news stories regarding abuse, theft, or neglect of long-term care residents are abundant yet repugnant to a society that aims to protect those that are physically and/or mentally frail.

Results of the evaluation found that, of the 204,339 completed screenings, 3.7% were disqualified due to criminal history, and 18.8% were withdrawn prior to completion for reasons that may include relevant criminal history.

The federally-funded pilot program points to a vital need to conduct thorough background checks for any potential senior caregivers, whether they be in an institutional or home setting.

The Administration on Aging has provided these tell-tale signs that a senior may be suffering elder abuse or neglect:

  • Bruises, pressure marks, broken bones, abrasions, and burns may be an indication of physical abuse, neglect, or mistreatment.
  • Unexplained withdrawal from normal activities, a sudden change in alertness, and unusual depression may be indicators of emotional abuse.
  • Bruises around the breasts or genital area can occur from sexual abuse.
  • Sudden changes in financial situations may be the result of exploitation.
  • Bedsores, unattended medical needs, poor hygiene, and unusual weight loss are indicators of possible neglect.
  • Behavior such as belittling, threats, and other uses of power and control by spouses are indicators of verbal or emotional abuse.
  • Strained or tense relationships, frequent arguments between the caregiver and elderly person are also signs.

Most importantly, be alert. The suffering is often in silence. If you notice changes in a senior’s personality or behavior, you should start to question what is going on.

President Barack Obama, in his 2012 presidential proclamation decreed June 15 as World Abuse Awareness Day stating, “Every American deserves the chance to live out the full measure of their days in health and security. Yet, every year, millions of older Americans are denied that most basic opportunity due to abuse, neglect, or exploitation. On World Elder Abuse Awareness Day, we call attention to this global public health issue, and we rededicate ourselves to providing our elders the care and protection they deserve.”

If you are a caregiver, consider taking Caregiverlist’s® Caregiver Training Course. With it, you can learn the types of abuse and neglect, legal requirements for reporting (and legal punishments for not reporting) and how to protect your senior client and yourself from physical, emotional, sexual and financial abuse.

Senior Driving Safety

School’s out and that means a whole slew of new teen drivers will be on the road. While the thought of a 16-year-old behind the wheel makes me nervous, senior drivers who have not recently evaluated their driving skills can also make me run for cover.

June is National Safety Month and the National Safety Council has designated this year’s theme as "Safety: It takes all of us," and was inspired by the idea of continuous risk reduction. The Council’s emphasis this year is on putting an end to distracted driving but I think its a great time to revisit the challenges facing the mature driver.

It’s been written that “Adult children would rather talk to parents about funeral plans than about taking away the car keys.” It’s a difficult conversation—many seniors associate driving with independence (that they don’t want to relinquish.) For the adult children of driving seniors, revoking that driving privilege can mean picking up the slack and becoming chauffeur to mom or dad, at least until Google’s self-driving car becomes available.

So how do you know if it’s time to take away the keys, or are there steps to ensure the senior can hang on to those keys just a little longer?

Caregiverlist® provides our own Safe Driving Checklist. We’ve provided some basic red-flags that might mean it’s time to reexamine a senior's on-road capabilities. These include:

  • Vision: Is the senior able to pass a vision test? (Cataracts, Glaucoma and Macular Degeneration can all impact vision quality).
  • Are there any unexplained dents in the paint of the car or on the garage?
  • Does the senior allow others to ride in the car with them when they are driving?
  • Does the senior seem nervous or extra anxious when driving? Does the senior take alternate routes to avoid major highways?
  • Does the senior fail to stop at red lights or stop signs?
  • Are speed limits obeyed (Not driving too slow or too fast)?
  • Have neighbors or others who see the senior driving (anyone who also attends a regular event they may drive to) observed anything unsafe? 

Also, talk to their physician to see if any of their medications can affect their driving ability.

If the above are not at issue and your senior is feels relatively safe to drive, the Massachusetts Registry of Motor vehicles suggests some self-imposed limitations which may include driving only during daylight hours, staying home when weather conditions are poor, avoiding rush hour, and driving less.

AAA, the leader in driver safety, offers many online tools to evaluate and improve senior driving skills. They also suggest taking driver improvement courses. These can teach older drivers how to adjust for slower reflexes, weaker vision and other changes. Taking and passing a comprehensive driving improvement course can result in potential discounts on insurance premiums.

It’s important that seniors realize the risks associated with accidents. Statistics say drivers age 85 and older are injured or killed in crashes at a higher rate than any other age group. This is due primarily to increased fragility that comes with age. Older senior drivers are generally less able to withstand the forces of a crash, so they are more likely to become injured.

Effective September 30, 2010, drivers 75 years of age or older can only renew a driver's license at an DMV branch or AAA office. The operator must either pass a vision test or present a completed Vision Screening Certificate. If you need to contact your local DMV, check out Caregiverlist’s® Department of Motor Vehicles by State list.

Louisiana Nursing Homes Rank Lowest in Nation, Report Says

Nursing homes in Louisiana are rated at or near the bottom in terms of quality of care compared to the rest of the nation, according to a recent state legislative report. The report is the result of an audit of utilization, cost, and quality of care in Medicaid nursing facilities as Louisiana considers privatizing its Medicaid long-term care program and votes on whether to lock-in nursing home prices.

The Louisiana Legislative Audit concluded that, while the number of nursing home residents decreased from 26,563 in July 2011 to 25,335 in November 2013, according data from the U. S. Agency for Healthcare Research and Quality (AHRQ), Louisiana is “far from the benchmark” for several quality of care indicators.

Long-stay nursing home residents in Louisiana have a higher incidence of pressure sores, increased depression or anxiety, are more likely to be physically restrained, and spend more time in bed or in a chair compared to the national nursing home average.

Caregiverlist® Nursing Home Star Ratings lists Louisiana’s average star rating at 2.5, with only 1 out of 303 nursing homes receiving a 5-star rating. Compare that to neighboring Arkansas whose nursing homes have an average 3.0 rating with 17 of its 268 nursing homes earning a 5-star rating, or Mississippi, whose average 2.8 rating includes 5 of its 225 nursing homes in the 5-star category.

Cited nursing home deficiencies, however, were predominantly for violations categorized as “no actual harm with potential for more than minimal harm.” These included:

  • Failure to implement care plan interventions, such as oral care, reporting skin changes to nurses, or providing showers according to plan of care. Failure to reassess the care plan and include the resident and/or their family in this process.
  • Failure to ensure wheelchairs have footrests or securing dangerous chemicals in the shower rooms.
  • Failure to develop a care plan to address pressure ulcers, hospice care, or foot care for diabetic residents.
  • Failure to conduct an accurate initial or ongoing assessment of resident's activities of daily living, dental problems, or transfer needs.

Prepared by legislative auditor’s staff using January 2014 Nursing Home Compare data and information provided by DHH.

In response, Associated Press’s Melinda Deslatte writes: Joe Donchess, executive director of the Louisiana Nursing Home Association, said Monday that the facilities in Louisiana and other nearby states are graded at a harsher standard by federal officials than similar facilities in other Medicaid regions. "We provide a high quality of care to the residents. The residents are happy and safe," he said. Donchess said the reviews don't take into consideration the conditions that patients have when they enter nursing homes. He said there's no way to judge that because the state doesn't monitor home- and community-based care programs for the elderly. He said if the programs don't provide quality care, nursing homes receive residents "in a weaker condition." The Louisiana Legislative Auditor plans future reports that will examine home and community-based services.

However, quality nursing home care can be found in Louisiana, especially according to Patrick D. McCarthy, a Lafayette CPA who, in a letter to the Advocate, writes about Southwest Louisiana Veterans’ Home in Jennings. “...An incomparable staff of qualified, caring personnel, delivers service with efficiency, professionalism and competency but, most importantly, with genuine affection and good humor. I am so sick of Louisiana being categorized at the bottom of most important lists. Truly we have a gem in Jennings. I invite you to visit. I guarantee that your chest will swell with pride for what we, Louisiana citizens, have at SLVH.”

Because many of us (or our senior loved-ones) may find themselves needing to choose nursing home care, it's up to us to do the due diligence and choose nursing home care wisely. Caregiverlist® provides a Nursing Home Checklist that can help you choose the right nursing home. 

Are Brain Games Vital to Great Senior Care?

Whenever my older sister misplaced things, or forgot a word or phrase, or walked into a room and couldn’t recollect why, she was fond of saying that she was having a “senior moment.” While it’s true that memory and processing speed can be challenged as we age, there are some aspects of the cognitive mind that are sharper in the elderly than in the young. Older people have a depth and breadth of knowledge and experience from which to draw. Decision-making processes can be stronger and certainly, the elderly probably have better language skills than their younger counterparts. But, as with the rest of the body, the mind should exercise or face possible atrophy.

According to Marbles, the Brain Store, the brain is malleable and can continue to create more neurons and neuronal connections, even older adults can exercise their brains and improve areas that they may not be as sharp in. SharpBrains, an independent research and advisory company on brain fitness, concurs. Cofounder and CEO Alvaro Fernandez states in an article on Social Work Today, that brain fitness is becoming a standard in older adult residential facilities, with more than 700 facilities in the United States alone installing computerized cognitive training programs since 2007.

Although I love computers, I wanted to find some good old-fashioned offline games to help increase brain strength. With that in mind (pun intended), I’ve enlisted the help of my local Marbles to give caregivers an idea of some games they can play with their seniors. Here are some of the suggestions from their website:

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Marbles Good Thinking Kit – This portable kit boasts over 100 activities to help improve memory, critical thinking, coordination, visual perception and word skills.

 

Pengoloo – Pengoloo is as much fun as one of penguins’ favorite pastimes: sliding down icy hills on their bellies! The best part? This charming game works your memory without you even realizing it. (The greatest brain health games are sneaky like that.)

 

Rush Hour – This multi-award winner is one of Marbles’ bestsellers; my kids love it too. Perhaps it’s the fun of setting up the game board based on pictures of traffic jams and then plotting your escape as you slide cars and trucks out of the way. Although it looks like a kid’s game, it’s challenging to even the best adult puzzlers.

 

 

 

Sherlock Deluxe – As Sherlock searches for clues, players are asked to recall objects on a facedown card. If the player is correct, the card is turned face-up and Sherlock moves on. If Sherlock lands on a face-up card, the player gets to keep that card. The first player to collect six cards wins. For adults, the game just might help you remember that you left your keys in the freezer.

 

And because we are not always around or available to play, a good solitary brain game continues to be:

Little Black & White Book of Crosswords – Of course, there areother crossword puzzles out there. But The New York Times Crossword is the gold standard. The bible. The one that all others are measured against. Now you can get 200 of these brilliant bad boys in The New York Times Little Black (and White) Book of Crosswords from puzzle master Will Shortz.

Caregiverlist® suggests that the next time you think of healthy aging and senior caregiving, remember to add some brain exercises. Along with physical activity and good nutrition, it will help you help your senior to age well.

Sun Safety Especially Important for Seniors

Ah, June! Finally, the cold, dreary days of winter are gone and the summer sun warms our bones. Last weekend, city pools were full to capacity. This is perfect weather — the recent numbing cold weather is a just a memory, and we well know that unbearable heat that will have us scrambling for air conditioning is right around the corner. But for right now, we will take advantage of these halcyon days and spend every available moment outdoors.

Before caregivers head outside with their seniors, it’s important to know that skin cancer is the most common type of cancer in the U.S. In fact, according to the Skin Cancer Foundation, the odds of developing skin cancer rise as you age; in fact, between 40 and 50 percent of Americans who live to age 65 will have at least one skin cancer.

Why is it that those over 70 years old have the highest incidence of skin cancer of any age group? I remember the days when baby oil was used as suntan lotion. A recent study conducted in Germany concluded that repeated sunburns during a lifetime increased the chances of melanoma later in life, writes Susan Evans, MD.

Tanning beds, introduced into the U.S. in 1979, were touted as the epitome of health and fitness. Tanning salons became hugely popular. However, we now know that using a tanning bed will increase your chances of getting skin cancer. The American Academy of Dermatology says studies have shown people who have been exposed to UV rays from indoor tanning have a 59% increase of developing melanoma, the most dangerous form of skin cancer. And just recently, the FDA reclassified them as "moderate-risk devices" instead of "low-risk". (The Skin Cancer Foundation, along with a host of other experts, feels that the reclassification doesn’t go far enough.)

But all is not lost. Damage can be mitigated and we can safeguard ourselves and our seniors from destroying any more precious skin cells. The following precautions can keep keep skin damage at a minimum and reduce the chance of future melanoma:

  • Wear waterproof sunscreen with an SPF of 30 or higher.
  • Cover up with broad brimmed hats, protective clothing, and UV-filtering sunglasses.
  • Seek shade instead of direct sunlight, especially during 10am and 4pm, when the sun is strongest.

In the meantime, seniors should arrange for regular skin cancer screenings with their doctors and educate themselves on what types of skin changes for which to be vigilant. Caregivers should also know the indicators of melanoma and be on the lookout for any skin anomalies.



Caregiverlist® invites you to learn more about helping seniors age well with Caregiverlist® Basic Training, powered by Caregiver Training University. The 8-hour training course provides easy-to-access online caregiver training for professional and family caregivers and meets senior caregiver orientation training requirements for many states.

German Nursing Homes to Try 3D Printed Food for Seniors

Senior caregivers can find it quite challenging to keep the elderly well-nourished, especially if the senior has problems with chewing and swallowing. A steady diet of baby food-like mush can make seniors dread their next meal. Dealing with the challenges of feeding those seniors can lead to caregiver stress.

So, the European Union is funding a consortium of five European countries along with 14 companies called PERFORMANCE (which stands for PERsonalised FOod using Rapid MAnufacturing for the Nutrition of elderly ConsumErs), to help develop 3D-printed “smoothfood” to create a more appetizing-looking meal.

German company Biozoon created Smoothfood, in which deconstructed foods that are safe to ingest without chewing are reconstructed to look like conventional meals by using plant-based solidifying agents and poured into food-shaped silicon molds. While the food retains its shape on the plate, it completely dissolves in the mouth, making it safe for those with chewing and swallowing impairments.

Dysphagia, or difficulty swallowing food, affects as many as 15 million Americans and according to the Agency for Health Care Policy and Research (AHCPR), over 60,000 Americans die from complications associated with swallowing dysfunctions each year. Many times, victims of stroke find themselves unable to chew and swallow regular food.Currently, those seniors have no choice but to eat a variety of pureed foods, much like baby food. Needless to say, a constant diet of unappealing and uninteresting food has been shown to cause a loss of appetite and lead to malnutrition.

Nursing homes and assisted living facilities are already overtaxed and overburdened with senior care, so the objective of the PERFORMANCE project is to utilize new processing approaches and tailor-made technologies for the use by small and medium sized (SME) food producers to produce personalised food for the frail elderly European consumer, thereby improving the quality of life.

Over 1,000 retirement homes in Germany have already implemented the smoothfood concept according to Wired UK. The PERFORMANCE project is hoping to take that idea and, by applying automated 3D printing technology, make it easier and more affordable to use on a broader scale by nursing homes and assisted living facilities.

But how does that food taste? Sandra Forstner, the project manager at Biozoon spoke to food blog Munchies about the taste of 3-D printed food. “The food tastes like normal food. It is made from fresh ingredients, so the taste doesn’t change. One of our goals is not to change the flavor; the texturizing system doesn’t change it.”

Multi-Generational Family Vacations

Memorial Day has passed and here in the Midwest, it’s finally beginning to feel like summer is around the corner. When that heat hits (and you know it will), the last place I’ll want to be in August is the sweltering city. That means it’s time to make some vacation plans.

“Family Vacation” was once used to mean nuclear family, or parents and their children. But that’s changing. I’m an active member of the Sandwich Generation — I take care of both my children and a parent. I am not alone. According to AARP, 66 million Americans between the ages of 40-65 find themselves caring for multi-generation family members. Those responsibilities don’t end when I get a little down-time. Just as I would need to make arrangements for my childrens’ care if I vacationed without them, I must also arrange for my mother’s senior care in my absence. And while I guess I could make other arrangements, I also believe that my elderly mother would also like a change of scenery and an excursion to look forward to. I also know that at 84, she can’t travel as she did at 64, so I have to approach this vacation a little differently.

Tips for traveling with seniors are all over the internet. It’s one of the fastest growing segments of the travel industry. If you are a family caregiver considering multigenerational travel, here are some tips I’ve gotten.

Check with the doctor and discuss activity comfort levels.
Clearance from the family doctor is important. Are there any vaccinations needed? Are medications up to date? Set the level of activity to a safe one. If mom can’t climb to the edge of an inactive volcano, she shouldn’t. But if she can, why not do it?

Be realistic about expectations.
Rome wasn’t built in a day, nor will you see it in one. I tend to push myself, and I remember the frustration of having to take a break every four hours for baby naps when the kids were young. The same time frame can hold true for seniors. Don’t overschedule and take frequent breaks.

Everyone gets Alone Time.
It’s very tempting to make grandma and grandpa the free babysitting service for nights on the town, but it should be everyone’s vacation. Enjoy the time together better by allowing for some time apart. Alone. That means seniors as well. If they’ve been leading a quiet life (I think I remember what that’s like), constant commotion of kids can be unnerving. But certainly take grandparents up on the offer and take advantage of a community of responsible adults.

Sometimes, you should just leave the planning to someone else. Cruise ships offer activities and entertainment suitable for all ages. Even Club Med, once the bastion of swingerdom, is getting in on the action by offering special deals and incentives catering to multigenerational family travelers.

I’m not sure if I’m crazy for giving this a go, but there’s no doubt we will all come away from this adventure with very special memories.

Honoring All Veterans this Memorial Day

Memorial Day weekend is typically filled with picnics, barbecues, and other events that signify the beginning of summer. But truly it is a day to remember those who died and honor those who remain, regardless of the wars in which they fought.

Frank Woodruff Buckles, Pershing’s Last Patriot, was the last surviving American veteran of World World I when he died in February, 2011. He was 110 years old.

America’s Wars, released by the Department of Veteran’s Affairs using some data from the Department of the Defense, provides the statistics for these eleven wars in the history of the United States:

  • American Revolution (1775-1783)
  • War of 1812 (1812-1815)
  • Indian Wars (approximately 1817-1898)
  • Mexican War (1846-1848)
  • Civil War (1861-1865)
  • Spanish-American War (1898-1902)
  • World War I (1917-1918)
  • World War II (1941-1945)
  • Korean War (1950-1953)
  • Vietnam War (1964-1975)
  • Desert Shield/Desert Storm (1990-1991)
    *the statistics don’t yet include numbers from the ongoing Global War on Terror (Oct 2001).

We are now standing witness to the passing of “the Greatest Generation,” those men and women who fought in World War II. In fact, they are the parents of the largest generation, the Baby Boomer Generation, spawned when those soldiers returned stateside and prospered. Those children are now planning for their own retirement and reviewing their own senior care options.

An enlisted man (or woman) 20-years-old in 1945, the last year of the Second World War, will turn 90 years old next year. Many are already in their nineties. Out of the 16 million who served their country during WWII, just over 1.7 million U.S. service members are alive today. According to the Veteran’s Administration, by 2036, it is estimated there will be no living veterans of World War II left to recount their experiences.

I heard about Honor Flight Network on NPR last week and was impressed by the group's committed to making sure the remaining WWII veterans get to Washington D.C. to see the memorials built in their honor at no cost.

If you are providing senior care to a WWII vet who would like to travel to Washington DC, time is of the essence, so be sure to contact Honor Flight Network. According to their website, subsequent to the World War II veterans, their efforts will then focus on our Korean War and then Vietnam War veterans, honoring them similarly. Contact your local hub for applications.

Here are some of the rough numbers to think about this Memorial Day:
Total number of U.S. Military Service during Wartime, from 1775 to 1991 (and remember, still counting): 41,892,128
Recorded Battle Deaths: 651,031

Caregiverlist® would like to take this space and remember all veterans. If you know of anyone who may be considering a career as a senior caregiver or who would like to just assist others, especially those who served in World War II, refer them to a senior caregiving job.

“We can’t all be heroes. Some of us have to stand on the curb and clap as they go by.”
— Will Rogers

IMPORTANT NOTE From Honor Flight Network: Honorflight.com and Honorflights.com are NOT associated with Honor Flight Network. (honorflight.org). The aforementioned sites and any other sites of companies that charge any fee to veterans are not affiliated in any way to Honor Flight Network. The flights and tours that Honor Flight Network provides World War II and terminally ill veterans are absolutely FREE.

10 Elder Care Tips to Make Senior Care Easier

Elder Law "Super Lawyer" Ben Neiburger shares 10 Elder Care Tips

May is Elder Law Month and when I hear “Elder Law,” I think of Caregiverlist® Elder Law Expert, Ben Neiberger. Since 1994, Ben has been giving legal and lay audiences a reprieve from some of the most complex and boring topics in the legal field (specifically, ERISA, Medicaid, and Eldercare). His delivery style helps you understand the important aspects of these topics in a way that gives you the ability to understand the legal issues you must know. Here, Ben shares his 10 Tips for surviving elder care to help you through the caregiving process and ensure you provide the best care possible for your loved one

Oh, and the moniker "Super-Lawyer" is real. Mr. Neiburger was named a “Super Lawyer” in Elder Law by Thompson Reuters and the publishers of Chicago magazine. Only three other attorneys in the state of Illinois were recognized this way in 2013. He also received this honor in 2007 and 2009 through 2014.

For Caregiverlist readers only, Ben is offering letting us give away his new ebook Brighter Skies: Your Blueprint to Navigating Elder Care. It’s a simple to understand guide that was written to make the process of Elder Care more bearable and less stressful for families. Follow these tips and you will spare yourself and your loved ones unnecessary pain in both the long and short terms.

Having practiced elder law for as long as I have, I've observed a number of issues that recur for families trying to negotiate the complex matters that come to the fore when assisting loved ones in the final stages of their life.

To that end, I’ve identified 10 principles that you need to pay attention to. Using these principles as a guide, you can develop strategies to help you and your family negotiate this very complex and emotional time.

Tip one – Put no one else before you and your family. You have a moral obligation to care for your parents, spouse and children. To do so well, you need to be informed, plan ahead, and take care of yourself first; the earlier the better.

Tip two – Let others help you. Find a trusted team of experts to help you through the health, legal and financial issues of end- of-life healthcare and planning. Geriatricians, care managers, elder law attorneys, accountants and financial planners are key advisors during this time.

Tip three – Act only with legal authority. There will come a time when you must make health-care and financial decisions for your elder when they cannot make decisions for themselves. Protect your loved one’s dignity and privacy by having them sign powers of attorney for property and health care before it’s too late.

Tip four – Rest. You are only human. Sometimes, the caregiving process requires an incredible amount of time, effort, blood, sweat, and tears. Even the strongest of us only last a matter of weeks or months before the stress of caregiving overwhelms our human capacity to provide that care. Hire caregivers, seek respite care, or let other family members, friends, or social agencies assist in providing care. You need rest and time to work and enjoy your own life, spouse and children. And only in doing so, will you be able to provide the best care for your loved one(s).

Tip five – Honor your loved one and preserve their independence as long as medically advisable. No one really wants to live in a nursing home. Most people want to live a dignified and independent life in their own home as long as possible. If it can be done safely, try to enable your loved one to live at home or in a non-nursing home community setting. If you want to support your parent in his or her home, but require additional funds for caregivers, reverse mortgages (including private family mortgages) can be a viable option.

Tip six –Make a financial plan. Assisted living and long-term care can be quite expensive. You need to take steps to ensure that your loved one’s funds last as long as possible. The longer his or her funds last, the more care options there are and the more independence they can have. Encourage your loved one to create a financial plan (including long-term care insurance, if possible) to generate enough income to cover long-term care at home, in an assisted living facility, or a nursing home when the time comes. Such a plan should be set up sooner than later.

Tip seven – Respect your loved one’s end-of-life wishes. As the last chapter of somebody’s life begins to close, the only thing many people have left is their family and personal dignity. It is your job as caregiver to do all you can to honor that dignity, as well as the wishes that preserve it. There will come a time when your loved one cannot tell you what they want. Take time to have a discussion with them beforehand on issues such as life-sustaining medical treatment and hospice, last rites, and their final resting place. Communicate these wishes to the entire family to ensure that such plans will be honored without familial strife when the time comes.

Tip eight – You can’t always control a progressive disease or sudden illness. There are some health conditions that improve with, and respond to treatment. There are others that do not, no matter what you do. Understand the condition or ailment that your loved one has, and do not expect miracles to occur as a result of treatment. Manage from that point forward. Many times, people do not recover from dementia, Alzheimer’s disease, or major strokes.

Tip nine – A nursing home placement isn't a death sentence. No one wants to go to a nursing home for their twilight years. Thirty or 40 years ago, families cared for loved ones at home until they died. Back then, people typically didn’t last longer than a few months, but with advances in medicine, the elderly now live on for years. Families need to rethink their objections to nursing homes because of the increase in end-of- life lifespans.

Tip ten – Try to mitigate family conflict. Family conflict at the end of a parent’s life is sometimes inevitable. However, an often unspoken wish for any person in the twilight of their life is the hope their children will get along after they pass on. A third-party is sometimes needed to assist in the decision making process. Sometimes transparency and disclosure will help. Other times, with a little more guidance and understanding, the children can make it through the process and keep their focus on ensuring their parents maintain their dignity as well as crucial family harmony.

I’ve create a series of short videos to further flush out these concepts. The goal is simple. Help you and your family make the best of a tough situation.

Ben is an active m

ember of the National Academy of Elder Law Attorneys (NAELA) and a member of the Executive Committee and Board of Directors for the Illinois Institute of Continuing Legal Education and through frequent speaking engagements and ongoing course work both locally and nationally, is in continuous pursuit of knowledge and insight to the laws and finances that affect our families and senior citizens. He brings this wealth of knowledge, his clear and common sense explanations, his patience, gentle humor and sensitivity to each of his legal consultations.To read more on each of these ten principles, go to generationlaw.com.

Caregiverlist's® Nursing Home Star-Ratings take the top criteria from the government inspection reports to help you choose the right and best nursing home for you or your loved one, if you should need one.

Senior Housing Building Boom: Too Much Too Soon?

I am part of a very substantial population of the United States known as Baby Boomers. According to the U.S. Census Bureau, 76.4 million American children were born post-World War II, between the years 1945 and 1964, making up almost 40% of the American population. As much as we would love to age in place, the fact is that if we see 80+ years old, we will need some sort of help with Activities of Daily Living, and the cold, hard truth is that a lot of us will receive that help in some sort of assisted living community.

It’s no wonder that many real estate developers are banking on building for a significant niche market. Home and commercial real estate building in 2014 point to a post-recession recovery. However, are those developing housing for the elderly building too much too soon?

Analysts say that a glut in the supply of senior housing is destined to hurt hurt health-care real estate investment trusts (REITs). Bloomberg News reported that the jump in supply is forecast to cut growth in senior-housing net operating income to 1.8 percent in 2015 and 1.4 percent in 2016 from 3.3 percent this year, according to Green Street Advisors Inc. These projections have translated into a 17 percent fall in the Bloomberg health-care REIT index during the last 12 months.

Brookdale Senior Living Inc. (BKD:US), is buying competitor Emeritus Corp. (ESC:US) for about $1.4 billion, Green Street Advisors told Bloomberg, making it the biggest owner of senior properties, with 1,161 senior care facilities in 46 states.

While the supply of senior care communities is increasing, the over-85 population is projected to increase to just 7 million by 2020. Senior housing won’t be in full swing for a few more years, when the nation’s “oldest old” could number as many as 31 million in 2050, although Jacob Gehl, managing director and founding partner of Blueprint Healthcare Real Estate Advisors, a brokerage and advisory firm in Chicago, told Bloomberg that peak demand is projected to be 15 to 20 years away.

It will be interesting to see how these new properties compete by way of staff, amenities, and senior housing costs. It will also be interesting to see if the trend in preferring to age at home with the assistance of quality home care continues. A lot can happen to the senior care landscape in 20 years.

Caregiverlist® would love to know about you and your family's projected needs. Where do you see yourself living when you are in need of assistance? Are you hoping your family will care for you? Do you see yourself moving into some sort of assisted living well before you absolutely need it?

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