“My Healthcare Wishes” App can save your life!

hands of old and youngYou may have gone to the trouble of making sure all your family members have completed the important documents that they need if they suffer a critical illness or have a terrible accident. But what if they (or you) are traveling and don’t have the appropriate documents with them? These documents include a durable power of attorney, a health care proxy, a living will and a DNR ( Do Not Resuscitate) order.

Now there is a solution. It is an Apple or Android app for the smartphone called “My Health Care Wishes”. It was created by the American Bar Association. Your family members don’t even need to have the app or a smartphone themselves as long as you have entered the information on your phone and they carry a wallet card indicating this. The information includes: contact information, summary of healthcare wishes, PDF copies of Advance Directives, Medical information, prescriptions, key medical contacts, healthcare proxy information and more.

Let’s say your Mom lives in San Francisco and has a health care directive with end-of-life decisions. You’re her primary proxy and live in Washington DC. She’s on vacation in Boston and rushed to the ER at Mass General Hospital. A My Health Care Wishes wallet card is found stating her proxy has her advance care plan on his iPhone—that’s you! You’re coaching soccer but with one click you are able to email the documents needed to speak with staff to make key decisions. Crucial moments are saved and you’re there in a way never possible before in a medical crisis.

Another example: Your Dad is 89 and your Mom is, 91. He takes her to the hospital and she’s admitted to the ICU but he’s told he can’t make medical decisions for her even if she is incapacitated. She’s his wife and he’s her proxy. What’s this about? He brought the wrong form with him! He brought the Power of Attorney document (POA) that only applies to financial & legal decisions. The Durable Health Care Power of Attorney (HCPOA) is what he needs but it’s at home and no one else is there. He has a cell phone, calls you, his daughter. You have what he needs securely stored on your Smartphone —the document showing your Dad as primary proxy. A click and the correct document is emailed, and your Dad losing little time tells doctors what his wife of 65 years wants.

The medical community is very complex and filled with rules and disclaimers. If you don’t have access to the right legal documents your life or another family member’s life may be in danger. Get on your computer right now and order “ My Health Care Wishes” from the Apple App Store or Google Play!

http://www.americanbar.org/groups/law_aging/MyHealthCareWishesApp.html

Have You Attended a Death Cafe?

Death CafeAt a Death Cafe people, often strangers, gather to eat cake, drink tea and discuss death.

Their objective is ‘to increase awareness of death with a view to helping people make the most of their (finite) lives’.

A Death Cafe is a group directed discussion of death with no agenda, objectives or themes. It is a discussion group rather than a grief support or counseling session.

Death Cafes are always offered:

- On a not for profit basis
- In an accessible, respectful and confidential space
- With no intention of leading people to any conclusion, product or course of action
- Alongside refreshing drinks and nourishing food – and cake!

Death Cafe is a ‘social franchise’. This means that people who sign up to the guide and principles can use the name Death Cafe, post events to the Death Café Website (www.deathcafe.com) and talk to the press as an affiliate of Death Cafe.

Death Cafes have spread quickly across Europe, North America and Australia. As of today, 803 Death Cafes have been offered since September 2011.

The Death Cafe model was developed by Jon Underwood and Sue Barsky Reid, based on the ideas of Bernard Crettaz.

Death Cafe has no staff and is run on a voluntary basis by Jon Underwood in Hackney, East London. Also Lizzy Miles who ran the first Death Cafe in the U.S. and Megan Mooney who runs the Death Cafe Facebook page have played a significant role in Death Cafe’s development.

People often ask why the Death Cafes are so popular. Everyone has their own reasons for getting involved in Death Cafe. – See more at: http://deathcafe.com/what/#sthash.eYN3ZxOa.dpuf

Major Breakthrough in Medicare Coverage for Chronic Illnesses

hands of old and youngFor years we have accepted the fact that Medicare will only cover physical therapy for patients who are continuing to improve. When my mother broke her hip the therapists informed her doctor that Medicare coverage for rehabilitation would cease after only three weeks of therapy. They told us that she would have to return to her assisted living residence even though she was still not able to walk. Their conclusion: She was no longer improving and it was likely she would never walk again.

Of course this was complicated by the fact that she had dementia and couldn’t remember the exercises they had prescribed for her a few minutes after she left the therapy room. But we accepted their conclusion without making a fuss and she has been in a wheelchair for the last five years.

But a major change has recently occurred in Medicare. One that has been kept very quiet but will have a huge impact on patients who have chronic illnesses. Medicare officials updated the agency’s policy manual in January. This is the rule book for everything Medicare does.  They stated that Medicare will now pay for physical therapy, nursing care and other services for beneficiaries with chronic illnesses like Multiple Sclerosis, Parkinson’s and Alzheimer’s disease in order to maintain their condition and prevent deterioration.

This dramatic change is due to the settlement of a class-action lawsuit filed in 2011 against Kathleen Sebelius , the Secretary of Health and Human Services by the Center for Medicare Advocacy and Vermont Legal Aid on behalf of four Medicare patients and five national organizations, including the National Multiple Sclerosis Society, Parkinson’s Action network and the Alzheimer’s Association. The settlement affects care from skilled professionals for physical, occupational or speech therapy and home health and nursing care, for patients in both traditional Medicare and private Medicare Advantage plans.

The change will have the greatest impact on seniors who want to avoid having to go into an institution to get care. People with chronic illnesses like Parkinson’s or MS may be able to get the care they need and stay in their own homes.

Existing eligibility criteria for Medicare rehabilitation benefits have not changed however. To be admitted to a rehab. facility or nursing home for covered care the patient must have spent three consecutive midnights in the hospital as an admitted patient and the patient must be referred by a Doctor’s order prescribing skilled nursing home care not custodial care.

For home health coverage, the beneficiary must have a Doctor’s order for intermittent care ( every few days or weeks) provided by a skilled professional or outpatient therapy, social work services or a visiting nurse. Beneficiaries receiving skilled services at home are also eligible for home health care aides for assistance with bathing, dressing and other daily activities.

The settlement also provides for a review of claims that were denied in the past three years solely because patients were not improving. Officials have posted a form on the Medicare site to repay beneficiaries for the care they paid for themselves. This form must be submitted by July 23, 2014 for claims that were denied from Jan. 18, 2011 to Jan. 24, 2014. Claims denied between Jan. 25, 2013 and Jan. 23, 2014 must be submitted by Jan. 25, 2015

Can Telemedicine Help Your Aging Parents?

TelemedicineWhat do you do if you can’t get your aging parent to a doctor’s office because of her disability? What do you do if your parent needs to see a specialist who may be hundreds of miles away? A new area of medicine known as Telemedicine may be the answer to your problem.

I first heard of this breakthrough  through the Parkinson’s Disease Foundation’s Newsletter, News & Review available at  www.pdf.orgThe newsletter described the advantages of Telemedicine for Parkinson’s patients. It offers them access to care, particularly to specialists, in locations that are remote or poorly served by medical resources. It also makes it easier for people with Parkinson’s to participate in clinical trials, which could speed up the development of new treatments.

A virtual medical appointment uses a computer, tablet or smartphone with technologies such as Skype or Facetime. These programs are available for free. Skype can be downloaded from www.skype.com. Facetime comes as a resident program on any Apple Computer, Iphone or IPad. Patients can communicate with and see their Doctor on the screen of the devise.

Early studies have indicated that the virtual visit may be more effective than seeing your doctor in person. It eliminates the hassle of travel to and from the doctor’s office and sitting in the waiting room. It also helps the doctor see you in your everyday environment. If your parent is prone to fall  it may help a doctor or therapist to identify risk factors and suggest ways to solve them.

Some studies have shown that during Telemedicine appointments, people are more relaxed, can communicate better with their doctors and can remember advice with greater accuracy. In a study done by the University of Rochester with people who have Parkinson’s Disease, researchers found that the quality of care was high and patients actually preferred the telemedicine visit.

According to the AmericanTelemedicineAssociation, www.americantelemed.org there are 3,500 sites around the US that offer telehealth in some capacity. More than 380,000 veterans received telehealth services from the VHA in 2011.

Telemedicine has demonstrated a significant impact on hospital admissions and emergency room visits, as well as, walk-in clinic visits. Ontario Telemedicine Network (OTN) conducted a trial program that involved more than 800 patients with one of two chronic diseases – Congestive Heart Failure or COPD. The results were:

  • 65% reduction in number of hospital admissions;
  • 72% reduction in number of Emergency Room visits; and
  • 95% reduction in number of walk-in clinic visits.

Telemedicine offers the possibility of shifting the delivery of many health care services from hospitals and other healthcare facilities to patient’s homes, thus reducing the load on the healthcare system and reserving hospitals for more critical cases.

One of the biggest hurdles for the expansion of Telemedicine is the patient’s ability to use the technology. We have probably all seen our elders wrestle with learning how to use email on their computers. But the use of a tablet or a computer with touch capability can make the communication almost as simple as dialing a phone.

Find out if your family doctor is familiar with the American Telemedicine Association (ATA). Ask them to check out the website, www.americantelemed.org to learn more about the exciting developments in this area. And see if it might work for them.

No Nursing Homes for Baby Boomers!

retirement communityMany families choose to stay in their home if one spouse needs long term care. But some can no longer stay there due to their needs or just the difficulties of moving about in the house. As 10,000 baby boomers reach retirement age every day, most who need care will not plan to enter a assisted living residence and will never step foot into a traditional nursing home. Increasing numbers will seek out new alternatives for independent living where care can be provided.

Intentional communities for philosophical, religious, and lifestyle groups are emerging. Wikepedia describes an intentional community as “ a planned residential community designed from the start to have a high degree of social cohesion and teamwork. The members of an intentional community typically hold a common social, political, religious, or spiritual vision and often follow an alternative lifestyle. They typically share responsibilities and resources.”

Alex Mawhinney (jamlll@charter.net) , a developer of retirement communities  for over 25 years, reports that “intentional elder neighborhoods are becoming the new paradigm for elder living.” He states that boomers will no longer be interested in “the older generation of elder living options that were available to our parents that follows this model:.

  • Age in place — in a home not designed for aging in place, and eventually aging alone
  • Move in with children or other relatives
  • Move to an institution — and pay dearly for care delivered by strangers, under their rules and according to their schedules. The institution might be a nursing home, an assisted living facility, a rest home, a retirement hotel, or a continuing care retirement community with multiple levels of care.

These elder neighborhoods are taking many different forms. It would behoove you to determine if any of them have been created in your community.

There are SOTELs (service-oriented technically enhanced living—like an upscale Embassy Suites); ecovillages; senior cohousing; and the new lifestyle communities like those being developed by Canyon Ranch.

The common traits of these new alternatives are that they are:

  • Human scaled ( not large and impersonal)
  • Relationship based
  • resident managed/centered, with an overlay of lifelong learning, later-life spirituality
  • giving back to the community

Early Retirement, Medicare, and How the Affordable Care Act Affects Seniors

Affordable Care ActChances are, if you’re alive, you know: the Affordable Care Act (commonly referred to as ‘Obamacare’) is here, and it’s confusing. Between trumped up rumors of plan cancellations and high penalties for those who don’t comply, more misconceptions seem to flood our screens than useful information. However, even if they are buried under layers of content, the facts exist. If you are 50 or older and retired or considering retirement, here are the facts that you need to know about the Affordable Care Act (ACA).

No Surprises

Before ACA, seniors often found themselves surprised by the cost of healthcare—especially if they were retiring before the age of 65. While some employers extend health benefits to retirees, many don’t, and finding affordable private coverage required access to the fountain of youth. Today, it is still legal to charge seniors five times the amount a 20-year-old would pay for the same policy on the private market—a cost that will be reduced to three times the amount in 2014.

Coverage will be much easier to find with the Health Insurance Marketplace, which will allow you to compare plans side-by-side.  Premiums may look more expensive at a first glance, but retirees living on less than they were while employed will qualify for subsidies that will help cover the cost of their premiums in the form of a tax break. If you’re under 65 and shopping on the marketplace, keep the amount of this subsidy in mind—your premium may appear to be over $1,000, but your tax break could lower it to less than half the cost. This amount is often lower than what you’d be paying for your COBRA through your former employer! The ACA will make it easier for you to retire before you’re eligible for Medicare, and you’ll qualify for coverage even if you have a preexisting condition.

Medicare Eligibility

If you’re over 65 and qualify for Medicare, you will be happy to know that Medicare still exists, and it is separate from the healthcare exchanges. In fact, the ACA will strengthen your policy if you qualify for Medicare. If you have Medicare Part D and have faced the price of prescription drugs in the doughnut hole, you’ll be happy to know that this gap will be shut for good by 2020. For now, you will receive a 20% discount on generic prescriptions and more than a 50% discount on brand-name prescription drugs while you are in the coverage gap.

Medicare now covers certain types of preventative care deductible-free, such as mammograms and colonoscopies. It also covers a free yearly “wellness” visit. The ACA has also extended the lifespan of the Medicare Trust—the fund has been extended until at least 2026.

Still Covered?

If you’re covered under your employer’s plan, the ACA also benefits you. More preventative care will be covered—everything from the flu shots to cholesterol screenings. All plans, whether purchased from the exchange or not, must cover the essentials starting in 2014, including hospital and emergency care, doctor visits, prescription drugs, and mental health.  If you have kids under the age of 26, then they can stay under your plan which saves you and them a ton of money.

So even if it seems maddening on the surface, the ACA will allow everyone to have access to the insurance that is appropriate to their needs. If you need help with the exchange, many businesses and community centers have events and programs that can help you through the process. Remember that insurance coverage is an important element to a successful retirement, and if you’re ready to retire early, the ACA has you covered.

Guest post written by: Edward Oberg, currently on hiatus from the insurance game, now spends his time blogging for The Hartford and hunting for monster brook trout that delight in mocking him. He has vowed to defy the accepted wisdom regarding boring insurance reps by being extremely interesting.

When do elderly people lose their youth?

http://www.daughterlycare.com.auMany of us direct our intentions to ensure that we enjoy a convenient stress-free healthy elderly life.

But when do elderly people really lose their youth and begin to fall prey to the psychological and emotional burdens of the elderly stages of life?

Factors that make elderly people lose their youth

There are 3 great factors that influence the loss of one’s youth.

  • Stress – No matter how old one becomes or how young one still is, the amount of stress greatly affects his or her ability to deal with aging. The human body experiences increased aging due to the hormones that need to be released in a stressful environment. When such processes are repeatedly experienced, the human body can no longer undergo reversible conditions thus fall prey to aging.
  • Support and coping – No matter how great the stress that elderly people experience, as long as they have the right coping mechanisms and support sources, they will stay healthy.
  • Information – When it comes to maintaining one’s youth, the amount of information that has been acquired to deal with all possible problems of aging matters a lot. This involves gathering as much information as possible in not only dealing with the common diseases and problems of elderly life but also maintaining quality of life despite old age.

When do you say goodbye to your youth?

After everything that has been said, you can easily tell when an elderly loses his or her youth. It is the point the he or she gives up and loses hope. Seeing the world through the eyes of youthfulness is seeing it with strength, hope, and glee. No matter how harsh, depressing, or hopeless a situation, with all 3 factors mentioned above adequately provided to your elderly, they will never lose their youth and fall prey to the a disastrous aging process.

this is a guest post written by Alana Vial of Daughterly Care. Please contact me at bob@giftofcommunication.com if you are interested in writing a guest post.

About Daughterly Care:

Daughterly Care is one of the leading privately owned agencies offering Homecare in NSW, which includes residential respite care.