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<channel>
	<title>Geriatric Care Management</title>
	<atom:link href="http://www.geriatriccaremanagement.com/feed/" rel="self" type="application/rss+xml" />
	<link>http://www.geriatriccaremanagement.com</link>
	<description>Helpful Advice and Support For Those Who Are Caring for an Aging Parent</description>
	<lastBuildDate>Mon, 16 Apr 2012 23:20:52 +0000</lastBuildDate>
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		<item>
		<title>The Impact of an iPod on Alzheimer&#8217;s</title>
		<link>http://www.geriatriccaremanagement.com/2012/04/the-impact-of-an-ipod-on-alzheimers/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/04/the-impact-of-an-ipod-on-alzheimers/#comments</comments>
		<pubDate>Sun, 15 Apr 2012 22:37:01 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Alzheimer's]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=8196</guid>
		<description><![CDATA[As Alzheimer&#8217;s moves through the brain, its only mission is to find and destroy memories. The first to go are the most recent ones (i.e. what happened five minutes ago, what one ate for breakfast). Eventually, the memories of the distant past are systematically wiped away like chalk on a blackboard. Watching a loved one [...]
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			<content:encoded><![CDATA[<p></p><p><iframe src="http://www.youtube.com/embed/5FWn4JB2YLU" frameborder="0" width="400" height="315"></iframe></p>
<p><span class="drop_cap">A</span>s <a title="Alzheimer’s" href="http://www.geriatriccaremanagement.com/alzheimers/">Alzheimer&#8217;s</a> moves through the brain, its only mission is to find and destroy memories.</p>
<p>The first to go are the most recent ones (i.e. what happened five minutes ago, what one ate for breakfast). Eventually, the memories of the distant past are systematically wiped away like chalk on a blackboard.</p>
<p>Watching a loved one go through this &#8211; as I know so many of you have &#8211; is painful and too often, agonizingly slow.</p>
<p>But HA HA Alzheimer&#8217;s!  Not all of our memories are so easy to find!</p>
<p>Like a home with a secret room buried deep in the earth beneath the foundation, our brains have deep compartments too.</p>
<p>And guess what memories are unknowingly stashed there year after year&#8230;  <span id="more-8196"></span></p>
<p>MUSIC MEMORIES.</p>
<p>If you&#8217;ve never seen the impact of an iPod on Alzheimer&#8217;s, take a look at the video above.</p>
<p>A man who barely talks anymore, after 10 years of battling the disease, comes alive again after listening to his favorite songs on an iPod. What&#8217;s more, the impact is sustained even after the music stops.</p>
<p>I can think of a no better way to spend <a href="http://www.apple.com/ipodshuffle/">$49</a>.</p>
<p>No related posts.</p>]]></content:encoded>
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		<item>
		<title>Arguing with Alzheimer&#8217;s</title>
		<link>http://www.geriatriccaremanagement.com/2012/04/arguing-with-alzheimers/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/04/arguing-with-alzheimers/#comments</comments>
		<pubDate>Mon, 09 Apr 2012 11:00:38 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Alzheimer's]]></category>
		<category><![CDATA[Maria's Mailbox]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=8076</guid>
		<description><![CDATA[Dear Maria, My 27-year old daughter complains that my 84-year old mother with Alzheimer&#8217;s says mean and hurtful things to her on purpose. She gets so hurt and angry that she will start yelling at my mother. When I try to get my daughter to realize it&#8217;s the Alzheimer&#8217;s making grandma act that way she [...]
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			<content:encoded><![CDATA[<p></p><h3><img class="alignleft size-medium wp-image-8082" title="" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/03/Alzheimers-Arguments-3.26.12-300x267.jpg" alt="" width="300" height="267" /><strong>Dear Maria,</strong></h3>
<p>My 27-year old daughter complains that my 84-year old mother with Alzheimer&#8217;s says mean and hurtful things to her on purpose. She gets so hurt and angry that she will start yelling at my mother.</p>
<p>When I try to get my daughter to realize it&#8217;s the Alzheimer&#8217;s making grandma act that way she says &#8220;No it&#8217;s not!&#8221; and expects me to &#8220;make grandma&#8221; stop treating her this way.</p>
<p>It always ends the same&#8230;everyone in tears, in separate rooms, not talking to each other the rest of the day, only to have something else trigger another &#8220;blow-up&#8221; the next day. (Finances right now are preventing my daughter and her family from moving.)</p>
<p>My daughter thinks I&#8217;m a bad mother because I don&#8217;t put grandma &#8220;in her place&#8221;. Is she right? OR how do I get my daughter to not take everything so personally.</p>
<p>I am in the middle of a very bad place, I would appreciate any advice you can give me.</p>
<p>Thanks, Diane (Riverside, CA)</p>
<p><em>(Diane has been a family caregiver to her mother for the past 8 years.)</em>  <span id="more-8076"></span></p>
<h3></h3>
<h3><strong>Dear Diane,</strong></h3>
<p>The person I&#8217;m most concerned about in the scenario you&#8217;ve laid out is you. Despite your daughter&#8217;s attempts to convince you otherwise, it isn&#8217;t your responsible to keep the peace in your household.</p>
<p>Your daughter is a grown woman; money may be preventing her from living elsewhere, but it&#8217;s not an excuse to behave like a teenager. Trying to be referee is a no-win position for you and no doubt adds to stress with which you are already coping.</p>
<p>The way forward (although it might be a little rocky at first) is to not allow yourself to get sucked into the middle. The next time your daughter comes to you with a complaint about grandma I would say and do the following:</p>
<blockquote><p>&#8220;It isn&#8217;t my responsibility to keep the peace between you and grandma.  You are a grown woman and I have tried numerous times to explain what&#8217;s going on.  If you don&#8217;t want to listen to me, that&#8217;s your decision, but I won&#8217;t allow you to upset me in the process any longer.&#8221;</p></blockquote>
<p>I&#8217;d recommend that you say this in the calmest voice you can and then,  I suggest that you stop whatever it is that you&#8217;re doing and leave the house for a minimum of 20 minutes&#8230;</p>
<p>Go for a walk around the block, take a short drive, it doesn&#8217;t matter. The important thing is to break the cycle of arguing with your daughter and allow her time to practice some new coping skills of her own.</p>
<p>When your daughter is able to talk with you again without the blaming and the anger, urge her to contact the Alzheimer&#8217;s Association.  Your local chapter will have classes that explain the illness in greater detail and I think she&#8217;d benefit from hearing this information from a professional. She can also call the 24/7 hotline for immediate feedback and advice.  This isn&#8217;t a bad number to have by the phone (1800-272-3900).</p>
<p>Lastly, and this is really important&#8230;YOU ARE NOT A BAD MOTHER. YOU ARE ALSO NOT A BAD DAUGHTER.  In fact it sounds to me like quite the opposite based on what you&#8217;ve shared.</p>
<p>If you&#8217;re not already connected to a support group, now would be a good time to join one.  You can find those resources through the Alzheimer&#8217;s Association too.</p>
<p>All the best,</p>
<p>Maria</p>
<p>No related posts.</p>]]></content:encoded>
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		<item>
		<title>Home or Nursing Home?</title>
		<link>http://www.geriatriccaremanagement.com/2012/04/home-or-nursing-home/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/04/home-or-nursing-home/#comments</comments>
		<pubDate>Thu, 05 Apr 2012 11:00:53 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Maria's Mailbox]]></category>
		<category><![CDATA[Planning Care]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=8065</guid>
		<description><![CDATA[Maria, Mom is in a nursing home/rehab to recuperate from a broken leg &#8211; the latest in a long list of injuries and illnesses over the last several years. She insists she wants to go home with the help of an aide but my 87-year-old stepfather does not feel that he can take care of [...]
No related posts.]]></description>
			<content:encoded><![CDATA[<p></p><h3><img class="alignleft size-medium wp-image-8067" title="Home or Nursing Home?" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/03/Home-or-Nursing-Home-3.26.12-205x300.jpg" alt="" width="205" height="300" /><strong>Maria,</strong></h3>
<p>Mom is in a nursing home/rehab to recuperate from a broken leg &#8211; the latest in a long list of injuries and illnesses over the last several years. She insists she wants to go home with the help of an aide but my 87-year-old stepfather does not feel that he can take care of her at home.</p>
<p>She has hospice due to her multiple diagnoses but doesn&#8217;t seem to be getting worse. She can rise from her wheelchair and walk ten feet with a walker although she is weak and sleeps a lot.</p>
<p>I don&#8217;t know how I am supposed to make a decision about her going home or staying in the nursing home. Any feedback from you would be helpful.</p>
<p>Sincerely, Bonnie (Fairfax, VA) </p>
<p><em>(Bonnie has been a family caregiver to her mom for the past 15 years.)</em>  <span id="more-8065"></span></p>
<h3><strong>Dear Bonnie,</strong></h3>
<p>You said two things that I think are key to making the decision between home or nursing home:</p>
<p>First, you mentioned that your mom is paying privately right now for a nursing home. I know that&#8217;s costing $10,000+ &#8211; money that could be used to pay for home care so that your father-in-law wouldn&#8217;t have to go it alone.</p>
<p>Second, your mom &#8220;insists she wants to go home.&#8221;</p>
<p>My strong advice is to consider honoring her wishes&#8230;</p>
<p>Switching the <a title="What’s Most Important To Know About Hospice" href="http://www.geriatriccaremanagement.com/2011/01/about-hospice/">hospice services</a> to home hospice would also help with the cost of home care. You may have to request it, but hospice does pay for 2-4 hours of home health aide services per day, 5 days per week. It would also cover the cost of any equipment needed to bring her home (e.g. a hospital bed, commode).</p>
<p>I hope this is helpful.</p>
<p>Maria</p>
<p>No related posts.</p>]]></content:encoded>
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		<title>Affording Incontinence Supplies Without Medicaid</title>
		<link>http://www.geriatriccaremanagement.com/2012/04/affording-incontinence-supplies-without-medicaid/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/04/affording-incontinence-supplies-without-medicaid/#comments</comments>
		<pubDate>Mon, 02 Apr 2012 11:00:53 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Benefits]]></category>
		<category><![CDATA[Maria's Mailbox]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=8045</guid>
		<description><![CDATA[Dear Maria, Dad is incontinent and is not able to afford the products he needs. I do the best I can, but I&#8217;m broke too.  He keeps dipping into his funeral savings, which is obviously not good. There has to be a way I can get these for him at least cheaper.  He has Medicare [...]
Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/adaptive-equipment/incontinence-aids/' rel='bookmark' title='Incontinence Aids'>Incontinence Aids</a></li>
<li><a href='http://www.geriatriccaremanagement.com/adaptive-equipment/incontinence-diapers/' rel='bookmark' title='For Many Men With Incontinence, Diapers May Seem to Be the Only Answer &#8211; Or Are They?'>For Many Men With Incontinence, Diapers May Seem to Be the Only Answer &#8211; Or Are They?</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2011/05/medicare-vs-medicaid-whats-the-difference-who-qualifies/' rel='bookmark' title='Medicare vs. Medicaid &#8211; What&#8217;s the Difference &amp; Who Qualifies?'>Medicare vs. Medicaid &#8211; What&#8217;s the Difference &#038; Who Qualifies?</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2012/01/when-to-transfer-assets-to-qualify-for-medicaid/' rel='bookmark' title='When to Transfer Assets to Qualify for Medicaid?'>When to Transfer Assets to Qualify for Medicaid?</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2012/03/medi-cal-vs-medicaid/' rel='bookmark' title='Medi-Cal vs. Medicaid'>Medi-Cal vs. Medicaid</a></li>
</ol>]]></description>
			<content:encoded><![CDATA[<p></p><h3><img class="alignleft size-medium wp-image-8050" title="" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/03/Adult-diaper-3.26.12-268x300.jpg" alt="" width="268" height="300" /><strong>Dear Maria,</strong></h3>
<p>Dad is incontinent and is not able to afford the products he needs. I do the best I can, but I&#8217;m broke too.  He keeps dipping into his funeral savings, which is obviously not good.</p>
<p>There has to be a way I can get these for him at least cheaper.  He has Medicare and Humana.</p>
<p>Please help!</p>
<p>Kathi (Edgewater, FL)  <span id="more-8045"></span></p>
<p><span style="color: #000080;"><em>(Kathi has been a family caregiver to her mother and father for the last five years.)</em></span></p>
<h3><strong>Hi Kathi,</strong></h3>
<p><strong>1)</strong> It&#8217;s possible that Humana (his supplemental insurance provider) might cover the cost of incontinence supplies on a limited basis, so I think it&#8217;s worth a call to them. Here&#8217;s a link to the <strong>Humana</strong> page where I found (finally!) their contact info: <a href="http://www.humana.com/resources/support_center/contact.aspx" target="_blank">http://www.humana.com/resources/support_center/contact.aspx</a></p>
<blockquote><p><span style="color: #000080;">Tip: Does your aging parent have a supplemental insurance policy &#8211; sometimes called a &#8220;Medigap&#8221; policy? If so, give them a call to see if incontinence supplies may be covered.</span></p></blockquote>
<p><strong>2)</strong> Make the most of free samples of incontinence supplies.</p>
<p>It looks like Tena offers free samples: <a href="http://www.tena.us/men/products/free-sample2/" target="_blank">http://www.tena.us/men/products/free-sample2/</a></p>
<p>It appears that Depends does too: <a href="http://www.depend.com/products/get-samples" target="_blank">http://www.depend.com/products/get-samples</a></p>
<p><strong>3)</strong> Start now to explore long term options for paying for needed supplies.</p>
<p>The best option of all long term may be <strong>Medicaid</strong>. Unless your dad has large assets he may qualify for Medicaid which would give him a lot of benefits he doesn&#8217;t have now including incontinence supplies, lower co-pays on meds, etc.</p>
<p>I did a search online to find out how to apply for Medicaid in Florida and came up with this link:</p>
<p><a href="http://www.myflorida.com/accessflorida/%20" target="_blank">http://www.myflorida.com/accessflorida/ </a></p>
<p>The page allows you to do a online screening which I&#8217;d say is worth a few minutes.</p>
<p>You can also call your local Medicaid office.  The contact info is on this page:</p>
<p><a href="http://portal.flmmis.com/FLPublic/Provider_AreaOfficePage/tabId/56/Default.aspx?AreaOffice=AREA%204" target="_blank">http://portal.flmmis.com/FLPublic/Provider_AreaOfficePage/tabId/56/Default.aspx?AreaOffice=AREA%204</a></p>
<p><strong>4)</strong> If your dad hasn&#8217;t been to the doctor in a while, now might be a good time.  There may be a treatable, underlying cause to his incontinence.</p>
<p>I hope this helps.</p>
<p>All the best,<br />
Maria</p>
<p>Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/adaptive-equipment/incontinence-aids/' rel='bookmark' title='Incontinence Aids'>Incontinence Aids</a></li>
<li><a href='http://www.geriatriccaremanagement.com/adaptive-equipment/incontinence-diapers/' rel='bookmark' title='For Many Men With Incontinence, Diapers May Seem to Be the Only Answer &#8211; Or Are They?'>For Many Men With Incontinence, Diapers May Seem to Be the Only Answer &#8211; Or Are They?</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2011/05/medicare-vs-medicaid-whats-the-difference-who-qualifies/' rel='bookmark' title='Medicare vs. Medicaid &#8211; What&#8217;s the Difference &amp; Who Qualifies?'>Medicare vs. Medicaid &#8211; What&#8217;s the Difference &#038; Who Qualifies?</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2012/01/when-to-transfer-assets-to-qualify-for-medicaid/' rel='bookmark' title='When to Transfer Assets to Qualify for Medicaid?'>When to Transfer Assets to Qualify for Medicaid?</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2012/03/medi-cal-vs-medicaid/' rel='bookmark' title='Medi-Cal vs. Medicaid'>Medi-Cal vs. Medicaid</a></li>
</ol></p>]]></content:encoded>
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		<item>
		<title>Medi-Cal vs. Medicaid</title>
		<link>http://www.geriatriccaremanagement.com/2012/03/medi-cal-vs-medicaid/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/03/medi-cal-vs-medicaid/#comments</comments>
		<pubDate>Thu, 29 Mar 2012 11:00:56 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Benefits]]></category>
		<category><![CDATA[Maria's Mailbox]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=8030</guid>
		<description><![CDATA[Hi Maria, My mom already has Medi-Cal and Medicare. Would she also qualify for Medicaid as well, and what&#8217;s the difference? I&#8217;m asking because she has incontinence and I have tried to get the supplies through Medicare, but they aren&#8217;t covered, so I pay for them. The cost adds up and I&#8217;m wondering if there&#8217;s [...]
No related posts.]]></description>
			<content:encoded><![CDATA[<p></p><h3><img class="alignleft  wp-image-8033" title="" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/03/Health-Icon-3.26.12-300x281.jpg" alt="" width="256" height="239" /><strong>Hi Maria,</strong></h3>
<p>My mom already has Medi-Cal and Medicare. Would she also qualify for Medicaid as well, and what&#8217;s the difference?</p>
<p>I&#8217;m asking because she has <a title="Incontinence Aids" href="http://www.geriatriccaremanagement.com/adaptive-equipment/incontinence-aids/">incontinence</a> and I have tried to get the supplies through Medicare, but they aren&#8217;t covered, so I pay for them. The cost adds up and I&#8217;m wondering if there&#8217;s another way.</p>
<p>Thanks in advance,</p>
<p>Cathy (Paramount, CA) <span id="more-8030"></span></p>
<h3><strong>Hi Cathy,</strong></h3>
<p>Medi-Cal is California&#8217;s version of Medicaid, so if you&#8217;ve got Medi-Cal, you&#8217;re all set.  It should cover the incontinence products up to a certain amount per month and usually through a doctor&#8217;s prescription.  <a title="Seven Things Medicare Still Doesn’t Pay For" href="http://www.geriatriccaremanagement.com/2011/01/seven-things-medicare-doesnt-pay-for/">Medicare doesn&#8217;t cover them at all</a>.</p>
<p>To understand the difference between Medicaid (Medi-Cal) and Medicare, check out the related posts below.</p>
<p>Hope this helps,<br />
Maria</p>
<p>No related posts.</p>]]></content:encoded>
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		<item>
		<title>Five Bathroom Safety Tips</title>
		<link>http://www.geriatriccaremanagement.com/2012/03/five-bathroom-safety-tips/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/03/five-bathroom-safety-tips/#comments</comments>
		<pubDate>Sat, 24 Mar 2012 16:39:41 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Age Well]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=8014</guid>
		<description><![CDATA[Hi Maria, It has been suggested that my 81 year old Mother have a safer bathroom. I&#8217;ve offered to pay for a higher toilet in the home I currently rent with my mother, but the landlord didn&#8217;t go for it. I&#8217;m also hesitant to move because mom is close to all of her doctors and [...]
Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/handicap-showers/' rel='bookmark' title='3 Steps to Bathroom Safety &#8211; Alternatives to Handicap Showers'>3 Steps to Bathroom Safety &#8211; Alternatives to Handicap Showers</a></li>
</ol>]]></description>
			<content:encoded><![CDATA[<p></p><p><img class="alignleft size-medium wp-image-8020" title="Five Bathroom Safety Tips" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/03/Green-Bathroom-Tiles-3.24.12-300x213.jpg" alt="" width="300" height="213" />Hi Maria,</p>
<p>It has been suggested that my 81 year old Mother have a safer bathroom.</p>
<p>I&#8217;ve offered to pay for a higher toilet in the home I currently rent with my mother, but the landlord didn&#8217;t go for it. I&#8217;m also hesitant to move because mom is close to all of her doctors and I am close to work.</p>
<p>Any suggestions?</p>
<p>Sincerely, Diane (Los Gatos, CA)</p>
<p>Dear Diane,</p>
<p>No need to renovate. Some basic bathroom safety equipment should do the trick.</p>
<h3>Five Bathroom Safety Tips:</h3>
<p>1. You&#8217;ll need a raised toilet seat. These are plastic, removable in under 10 seconds if you don&#8217;t prefer to use it, and come with handles.</p>
<p>2. A shower chair is essential so mom does not have to stand in the shower.  Bare feet, soap, and water are a recipe for a fall which is the number one thing you are trying to avoid.</p>
<p>3. Get a handheld shower.  These pieces easily attach to the existing shower head and have long cords for easy bathing while sitting down.</p>
<p>4. Grab some grab bars.  If you had the support of your landlord I&#8217;d suggest that they be screwed into the walls. But since you don&#8217;t, pick up the ones that suction to the surface of the wall. These are better than nothing.</p>
<p>5. Get rid of throw rugs that can slip and slide. Instead, consider buying a piece of thick, remnant carpet that can be cut to fit the entire bathroom floor.</p>
<p>Hope this helps,</p>
<p>Maria</p>
<p>P.S. Many of the items I&#8217;ve just mentioned can be found in my <a href="http://astore.amazon.com/gcmstore7.31.11-20">Amazon Store</a> or by clicking on the Store link above.</p>
<p>Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/handicap-showers/' rel='bookmark' title='3 Steps to Bathroom Safety &#8211; Alternatives to Handicap Showers'>3 Steps to Bathroom Safety &#8211; Alternatives to Handicap Showers</a></li>
</ol></p>]]></content:encoded>
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		<item>
		<title>Mom Is On A Sudden Decline, What Can I Do?</title>
		<link>http://www.geriatriccaremanagement.com/2012/03/mom-is-on-a-sudden-decline-what-can-i-do/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/03/mom-is-on-a-sudden-decline-what-can-i-do/#comments</comments>
		<pubDate>Sat, 10 Mar 2012 16:11:45 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Planning Care]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7988</guid>
		<description><![CDATA[A woman from Michigan got in touch recently to express this very sentiment. Mom, a spry 89 year-old who was very active until a few months ago, suffered a fall and hasn&#8217;t been the same since. In fact, she&#8217;s worse than ever. After a pair of hospitalizations and a stay in a sub acute rehab, [...]
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			<content:encoded><![CDATA[<p></p><p><img class="alignleft size-medium wp-image-8001" title="Mom Is On a Sudden Decline, What Can I Do?" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/03/rain-cloud-300x300.jpg" alt="" width="300" height="300" /><span class="drop_cap">A</span> woman from Michigan got in touch recently to express this very sentiment.</p>
<p>Mom, a spry 89 year-old who was very active until a few months ago, suffered a fall and hasn&#8217;t been the same since. In fact, she&#8217;s worse than ever.</p>
<p>After a pair of hospitalizations and a stay in a <a title="Three Things You Should Know About Sub-Acute Rehab (SAR)" href="http://www.geriatriccaremanagement.com/2011/12/sub-acute-rehab/">sub acute rehab</a>, she complains of vertigo constantly and feels that she&#8217;s &#8220;seasonally depressed&#8221;.</p>
<p>In the span of two months she&#8217;s become disinterested in most activities. Unwilling to bathe or dress most days, she&#8217;s also lost interest in cooking which she once loved.</p>
<p>And those social outings? Seems like they&#8217;re a thing of the past.</p>
<p>&#8220;What can I do to keep her happy and comfortable?&#8221; her daughter writes. &#8220;I see her shutting down physically even though mentally she&#8217;s aware.&#8221;</p>
<p>So can you relate to this daughter&#8217;s feeling of being in a nebulous No-Man&#8217;s Land somewhere in the Elder Care Wilderness?</p>
<p>If so, read on for some tips to chew on&#8230;<span id="more-7988"></span></p>
<p><strong>1. Make sure mom is connected to a really good primary care provider (PCP) &#8211; in other words, a doctor who knows her (or will get to know her).</strong></p>
<p>A geriatrician is best.</p>
<p>A <a title="Is Your Aging Parent’s Doctor Good Enough?" href="http://www.geriatriccaremanagement.com/2011/10/is-your-aging-parents-doctor-good-enough/">geriatrician</a> whose office isn&#8217;t far from your aging parent&#8217;s home is ideal.</p>
<p><strong>2: Schedule an appointment that you can both attend and bring every single medication your mother takes including vitamins and supplements with you.</strong></p>
<p>If you have a half hour to spare beforehand, do the doctor a favor and write down all the medication names, dosages, and when they&#8217;re taken in a notebook so they&#8217;ll be easier to review.</p>
<p>Why is this important?</p>
<p>Because physical symptoms that seemingly come out of nowhere should always raise your <a title="Three Ways to Help Mom Manage Her Medications" href="http://www.geriatriccaremanagement.com/2011/01/help-mom-manage-her-medications/">medication interaction</a> red flag.  Especially if your parent visits more than a few doctors who routinely prescribe meds.</p>
<p>Maybe the blue pill is exactly the same as the big red one and mom is taking both daily.</p>
<p>Maybe the pink one should be taken with food, but mom has been taking it on an empty stomach&#8230;</p>
<p>If a few of these maybes turn out to be yeses, no one should be surprised that mom feels dizzy, lightheaded or lethargic.</p>
<p><strong>3. Consider the fact that mom may need some physical therapy to strengthen her muscles.</strong></p>
<p>If mom has Medicare, ask that doctor to please order some home physical rehab (a.k.a. Home PT). This is a covered benefit and can make a substantial impact on her ability to feel confident on her own two feet again. Lack of activity can lead to <a title="The Key To Fall Prevention" href="http://www.geriatriccaremanagement.com/2010/12/fall-prevention/">weakened muscles</a>.</p>
<p><strong>4. Take a deep breath.  Seriously.</strong></p>
<p>Watching a loved one decline before your eyes in a short amount of time is bound to produce anxiety and fear.</p>
<p>Try not to catastrophize.  The fact that mom lived 89 years (or however long in your mom&#8217;s case) being an active, social person, bodes well for her now.  Try not to assume it is the beginning of the end.</p>
<p><strong>5. Understand that mom may be catastrophizing too. Offer support.</strong></p>
<p>If you sense that your aging parent is giving up on things ever being as they once were, talk about it. Tell her that it&#8217;s easy to slip into that thinking and encourage her to hold off.</p>
<p>It isn&#8217;t time to throw in the towel.</p>
<p>No related posts.</p>]]></content:encoded>
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		<title>When to Transfer Assets to Qualify for Medicaid?</title>
		<link>http://www.geriatriccaremanagement.com/2012/01/when-to-transfer-assets-to-qualify-for-medicaid/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/01/when-to-transfer-assets-to-qualify-for-medicaid/#comments</comments>
		<pubDate>Tue, 10 Jan 2012 12:00:28 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Planning Care]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7955</guid>
		<description><![CDATA[It&#8217;s a topic I&#8217;ve not yet covered on this blog, but one that I&#8217;m asked about consistently by adult daughters and sons alike: When should I transfer assets so that my aging parent qualifies for Medicaid? The most recent person to broach the subject with me was Michael from New York City.  His mother had [...]
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			<content:encoded><![CDATA[<p></p><p><img class="alignright size-medium wp-image-7972" title="estate planning" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/01/estate-planning-290x300.jpg" alt="" width="290" height="300" /><span class="drop_cap">I</span>t&#8217;s a topic I&#8217;ve not yet covered on this blog, but one that I&#8217;m asked about consistently by adult daughters and sons alike:</p>
<h3><strong><em>When should I transfer assets so that my aging parent qualifies for Medicaid?</em></strong></h3>
<p>The most recent person to broach the subject with me was Michael from New York City.  His mother had a stroke in 2009 that left her with severe short-term memory loss.</p>
<ul>
<li>She can&#8217;t drive, plan meals, or cook for herself.</li>
<li>She despises Meals-on-Wheels.</li>
<li>She takes some medications to prevent seizures and others to help with the memory loss.</li>
<li>She lives in a condo and wants to stay there with supportive services (no live-in caregivers thank you very much).</li>
</ul>
<p>BUT&#8230;</p>
<p>Michael&#8217;s sister is insisting on moving mom to an assisted living facility. Michael feels this is premature and will wipe out mom&#8217;s assets and send her to a nursing home earlier than necessary.</p>
<p>&#8220;So,&#8221; he asks me, &#8220;should we transfer assets so that she qualifies for Medicaid?&#8221;<span id="more-7955"></span></p>
<p>My answer to Michael would be the same for anyone else: <strong>Maybe.</strong> <strong>But not without some legal guidance and a clear understanding of the problem you&#8217;re trying to solve.</strong></p>
<p>Yes, Medicaid pays for nursing home care.  But qualifying for this type of Medicaid is not as easy as removing funds from a bank and closing an account.</p>
<p>Think about this from the state&#8217;s perspective&#8230;</p>
<p>With mom&#8217;s blessing, Michael removes money from her account and then what&#8230;?</p>
<p>The state foots the bill for mom&#8217;s nursing home bed through the end of her life?</p>
<p>No way.</p>
<p>Instead, the state wants to be certain mom can&#8217;t contribute to the costs.</p>
<p>To get that assurance, they do what is commonly known as a &#8220;look back&#8221; &#8211; a financial audit that can stretch back as many as five years.</p>
<p><strong>One guess what they do when they find the transfer mom authorized Michael to make&#8230;</strong></p>
<p>They call a foul and tell mom that she can&#8217;t qualify for Medicaid until she spends the transferred money.</p>
<p>If she&#8217;s in a nursing home, they let her pay for the cost of those services until her money is spent down to the Medicaid limit and then they reconsider her application.</p>
<p>If she&#8217;s not in a nursing home, she&#8217;s invited to spend down her money in other ways until she reaches the Medicaid limit.</p>
<p><strong>Are there ways of sheltering assets so that Medicaid will pay for the nursing home and Michael and his sister can inherit something?</strong></p>
<p>Yes.</p>
<p>But don&#8217;t kid yourself. This is legal territory. Don&#8217;t venture into it without a lawyer.</p>
<p>In the meantime, Michael&#8217;s mom is in need of help at home. The really good news in this scenario is that she is open to help so long as it doesn&#8217;t come in the form of a live-in caretaker.</p>
<p>Knowing that, I&#8217;d advise Michael to ensure that mom gets the kind of help she&#8217;s open to right away to see if it makes a positive difference.</p>
<p>If it does, maybe a higher level of care can wait.</p>
<p>If it doesn&#8217;t, it may very well be time.</p>
<p>No related posts.</p>]]></content:encoded>
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		<title>When Your Mother-In-Law Wants to Move In and It&#8217;s Not What You Want</title>
		<link>http://www.geriatriccaremanagement.com/2012/01/mother-in-law-wants-to-move-in/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/01/mother-in-law-wants-to-move-in/#comments</comments>
		<pubDate>Fri, 06 Jan 2012 12:00:10 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Planning Care]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7896</guid>
		<description><![CDATA[A reader I&#8217;ll call Margaret got in touch recently to ask about the mother (pun intended!) of all planning care conundrums: her mother-in-law wants to move in&#8230; Dear Maria, My mother-in-law has decided she doesn&#8217;t want to live alone any longer and wants to sell her big house. My husband and I agree completely (her [...]
Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/2010/08/home-monitoring-equipment/' rel='bookmark' title='Hey Mom! How About I Monitor Your Every Move?!'>Hey Mom! How About I Monitor Your Every Move?!</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2011/09/have-mom-live-with-me-or-move-her-to-a-nursing-home/' rel='bookmark' title='&#8220;Have Mom Live with Me or Move Her to a Nursing Home?&#8221;'>&#8220;Have Mom Live with Me or Move Her to a Nursing Home?&#8221;</a></li>
</ol>]]></description>
			<content:encoded><![CDATA[<p></p><p><span style="color: #000000;"><img class="wp-image-7925 alignright" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/01/house-key-228x300.jpg" alt="" width="185" height="243" /><span class="drop_cap">A</span> reader I&#8217;ll call Margaret got in touch recently to ask about the mother (pun intended!) of all <a title="What to Cover When You Talk with Your Aging Parents About the Future" href="http://www.geriatriccaremanagement.com/2011/07/what-to-cover-when-you-talk-with-your-aging-parents-about-the-future/">planning care</a> conundrums: her mother-in-law wants to move in&#8230;<br />
</span></p>
<blockquote><p><span style="color: #000000;">Dear Maria,</span></p>
<p><span style="color: #000000;">My mother-in-law has decided she doesn&#8217;t want to live alone any longer and wants to sell her big house. My husband and I agree completely (her short-term memory is getting really bad, the house is very big and remotely located).</span></p>
<p><span style="color: #000000;">Without consulting us, she planned to &#8220;rent a room&#8221; in our home. However, when she shared this plan, my husband said <span id="more-7896"></span>no &#8211; for a variety of legitimate reasons. Now we don&#8217;t quite know what to do. She is adamantly opposed to the following:</span></p>
<ul>
<li><a title="Assisted Living Facilities: Weighing the Pros and Cons of One of the Biggest Trends in Long-Term Care" href="http://www.geriatriccaremanagement.com/elder-care-101/planning-care/assisted-living-facilities/"><span style="color: #000000;">assisted living communities</span></a></li>
<li><span style="color: #000000;">apartments in a senior development</span></li>
<li><span style="color: #000000;">buying a smaller, more manageable house near us</span></li>
</ul>
<p><span style="color: #000000;">Any suggestions on how to proceed?</span></p>
<p><span style="color: #000000;">We want her to be safe, healthy and happy, but there don&#8217;t seem to be any &#8220;good&#8221; options.</span></p></blockquote>
<p style="text-align: center;">It almost goes without saying, but THIS ONE IS A DOOZY.</p>
<p>Now that I&#8217;ve said that&#8230;</p>
<h3>The first thing to do in any planning care situation is to openly acknowledge the pluses&#8230;</h3>
<p>Here are the pluses I see in this scenario:</p>
<ol>
<li>Mom recognizes that her current living situation is not working&#8230;</li>
<li>She instinctively knows that she benefits from <a title="Why Community Is Critical As We Age" href="http://www.geriatriccaremanagement.com/2010/05/why-community-is-critical-as-we-age/">being around others</a> as opposed to being alone and&#8230;</li>
<li>She feels ready to do something about 1 &amp; 2 above. And not just something; she&#8217;s ready to sell her house. This is a huge step and one that lots of folks don&#8217;t ever get past</li>
<li>Margaret and her husband are in agreement that mom moving in is not workable (I wouldn&#8217;t point this one out to mom, but it is a very important plus!)</li>
</ol>
<p>Next, do as Margaret&#8217;s husband did and&#8230;</p>
<h3>Have a conversation with the older adult in which you acknowledge the situation&#8217;s pluses AND your own limits</h3>
<p>Will the latter half of this be uncomfortable for you? Most likely.</p>
<p>Might it cause your mother to become upset, which in turn may make you more uncomfortable? I&#8217;m going to say yes to this one.</p>
<p>But understand that agreeing to a plan that you know in your gut is not sustainable will only hurt you and the older adult in the long run.</p>
<p>So you&#8217;ve honored the pluses and your limits&#8230;</p>
<h3>Next you&#8217;ve got to give your mom/dad some time to absorb what you&#8217;ve said.</h3>
<p>This isn&#8217;t likely to happen in a half hour or even overnight.  In a situation like Margaret&#8217;s where the truth hurts (I&#8217;m assuming that mom heard the &#8220;No&#8221; from her son as a big OUCH), it may even take a few months.</p>
<p>Don&#8217;t despair. Let the dust settle. Keep your defenses down and the lines of communication open&#8230;</p>
<p>The best sign of progress would be that mom agrees to humor Margaret and her husband and check out a few assisted livings or continuing care retirement communities (CCRCs).  In other words, she agrees to rethink the alternatives to which she was adamantly opposed.</p>
<p>ACKNOWLEDGE ANY MOVEMENT IN THAT GENERAL DIRECTION and keep your seatbelt on.</p>
<p>Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/2010/08/home-monitoring-equipment/' rel='bookmark' title='Hey Mom! How About I Monitor Your Every Move?!'>Hey Mom! How About I Monitor Your Every Move?!</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2011/09/have-mom-live-with-me-or-move-her-to-a-nursing-home/' rel='bookmark' title='&#8220;Have Mom Live with Me or Move Her to a Nursing Home?&#8221;'>&#8220;Have Mom Live with Me or Move Her to a Nursing Home?&#8221;</a></li>
</ol></p>]]></content:encoded>
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		<title>What Do Family Caregivers Need Most? In a Word &#8211; Support.</title>
		<link>http://www.geriatriccaremanagement.com/2012/01/family-caregivers-need-support/</link>
		<comments>http://www.geriatriccaremanagement.com/2012/01/family-caregivers-need-support/#comments</comments>
		<pubDate>Tue, 03 Jan 2012 12:00:59 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Caregiver Support]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7854</guid>
		<description><![CDATA[A few weeks ago a reader I&#8217;ll call Cara got in touch to tell me about her mom Jeannie.  Recently divorced and concerned for her father&#8217;s health, Jeannie moved her father into her home. Immediately, there were benefits. Dad liked the companionship he&#8217;d been missing since his wife died, and Jeannie liked biding adieu to [...]
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<li><a href='http://www.geriatriccaremanagement.com/2011/01/working-caregiver-tips/' rel='bookmark' title='Five Tips For Busy Family Caregivers With &#8220;Day&#8221; Jobs'>Five Tips For Busy Family Caregivers With &#8220;Day&#8221; Jobs</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2011/06/what-makes-a-support-group-worthwhile/' rel='bookmark' title='What Makes A Support Group Worthwhile'>What Makes A Support Group Worthwhile</a></li>
</ol>]]></description>
			<content:encoded><![CDATA[<p></p><p><img class="alignnone size-medium wp-image-7884" title="What Family Caregivers Need Most" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2012/01/What-Family-Caregivers-Need-Most-300x191.jpg" alt="" width="300" height="191" /><span class="drop_cap">A</span> few weeks ago a reader I&#8217;ll call Cara got in touch to tell me about her mom Jeannie.  Recently divorced and concerned for her father&#8217;s health, Jeannie moved her father into her home.</p>
<p>Immediately, there were benefits.</p>
<p>Dad liked the companionship he&#8217;d been missing since his wife died, and Jeannie liked biding adieu to the thrice-weekly one hour drives to dad&#8217;s house that had become the norm.</p>
<p>It&#8217;s six months later and Jeannie is happy with her decision; her father&#8217;s health has even improved.</p>
<p>But something isn&#8217;t working in this caregiving scenario <span id="more-7854"></span>and that something threatens the whole arrangement. The problem is this:</p>
<p>Jeannie&#8217;s siblings (who promised otherwise) have all but left the picture.</p>
<p>Jeannie&#8217;s brother, who lives ten minutes away, looks for excuses not to visit.  Her sister, who used to visit regularly, cancels at the last minute without explanation or apology.</p>
<p>All of this is upsetting to Jeannie and has, in turn, become upsetting to Cara&#8230;</p>
<p>&#8220;I wondered if you had any advice on how I could best make my mom feel special and appreciated. Hallmark cards are getting old and I know I sound like a broken record on our nightly venting calls&#8230;&#8221;</p>
<p>My advice to Cara &#8212; and to anyone else who may be caring for a caregiver &#8212; is this:</p>
<p>Keep lending your ear and whenever possible, your hands. Don&#8217;t assume that the primary family caregiver has things covered.  In other words, don&#8217;t step back &#8211; especially if that primary person is your sibling.</p>
<p>Make a point to recognize and appreciate what they do.</p>
<p>Whether you live close by or far away, practice being a soft place to fall and also someone who lightens the load every now and again. Family caregivers need support most.</p>
<p>Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/2011/01/working-caregiver-tips/' rel='bookmark' title='Five Tips For Busy Family Caregivers With &#8220;Day&#8221; Jobs'>Five Tips For Busy Family Caregivers With &#8220;Day&#8221; Jobs</a></li>
<li><a href='http://www.geriatriccaremanagement.com/2011/06/what-makes-a-support-group-worthwhile/' rel='bookmark' title='What Makes A Support Group Worthwhile'>What Makes A Support Group Worthwhile</a></li>
</ol></p>]]></content:encoded>
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		<title>How To Overcome Feeling Overwhelmed</title>
		<link>http://www.geriatriccaremanagement.com/2011/12/how-to-overcome-feeling-overwhelmed/</link>
		<comments>http://www.geriatriccaremanagement.com/2011/12/how-to-overcome-feeling-overwhelmed/#comments</comments>
		<pubDate>Sat, 31 Dec 2011 15:05:00 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Caregiver Support]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7773</guid>
		<description><![CDATA[Last week I cracked the crown on &#8220;tooth #30&#8243;. It hurt. But not as much as the pain that would have come with replacing it with my out-of-network dentist&#8230;$750. &#8220;No way,&#8221; said my husband. I shared his sentiment and so the hunt for an in-network dentist who would see me fast began. I was lucky [...]
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<li><a href='http://www.geriatriccaremanagement.com/respite/' rel='bookmark' title='Respite: A Lifeline For Those Overwhelmed By Caregiving'>Respite: A Lifeline For Those Overwhelmed By Caregiving</a></li>
</ol>]]></description>
			<content:encoded><![CDATA[<p></p><p><img class="alignleft size-medium wp-image-7835" title="Into every life..." src="http://www.geriatriccaremanagement.com/wp-content/uploads/2011/12/rain-cloud-300x298.jpg" alt="" width="300" height="298" /><span class="drop_cap">L</span>ast week I cracked the crown on &#8220;tooth #30&#8243;. It hurt. But not as much as the pain that would have come with replacing it with my out-of-network dentist&#8230;$750.</p>
<p>&#8220;No way,&#8221; said my husband.</p>
<p>I shared his sentiment and so the hunt for an in-network dentist who would see me fast began. I was lucky to find a good one who patched me up a few days later.</p>
<p>So here&#8217;s what I left out of my little intro story above&#8230;</p>
<p>The cracked crown brought me to tears.  Big ones.  There was some sobbing involved too which was accompanied by <span id="more-7773"></span>the feeling of being completely overwhelmed. But why?</p>
<p>I&#8217;ve decided to share my meltdown story with you because I think a lot of people can relate. <strong>It was so obviously <em>not</em> about the crown.</strong></p>
<p>Life is packed with to-dos and for many of us, the pace is unrelenting. Months can fly by like weeks, and at the same time, a particularly tough week can feel like two.</p>
<p>Like a cup that fills up one drip at a time, it is incredibly easy to lose track of what we&#8217;re carrying until there just isn&#8217;t room to carry anymore. The only thing left to do is to empty our cup&#8230;</p>
<p>So as the tissues dwindled, I put pen to paper and wrote down the things on my mind in that moment. I just let them spill out of me like the tears.</p>
<p>And you know what surprised me? It wasn&#8217;t long until I had listed eight things. Eight!</p>
<p>Something else surprised me too&#8230;the act of naming my worries &#8211; of transferring them to the page &#8211; instantly made me feel lighter. The tears stopped and I began to feel more in control.</p>
<p>Have you tried this?  Do you know how long your list would be?</p>
<p>Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/respite/' rel='bookmark' title='Respite: A Lifeline For Those Overwhelmed By Caregiving'>Respite: A Lifeline For Those Overwhelmed By Caregiving</a></li>
</ol></p>]]></content:encoded>
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		<title>Two Reasons to Hire A Geriatric Care Manager Now</title>
		<link>http://www.geriatriccaremanagement.com/2011/12/hire-a-geriatric-care-manager-now/</link>
		<comments>http://www.geriatriccaremanagement.com/2011/12/hire-a-geriatric-care-manager-now/#comments</comments>
		<pubDate>Thu, 08 Dec 2011 12:00:33 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Hiring Help]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7608</guid>
		<description><![CDATA[I have the utmost respect for geriatric care managers, but I&#8217;m also a realist about the fact that not everyone can afford one. However, even when money is tight, there are a few instances in which the cost of a geriatric care manager is well worth it. Below are the top two reasons to hire [...]
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<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-manager-directory/' rel='bookmark' title='Join The Geriatric Care Manager Directory!'>Join The Geriatric Care Manager Directory!</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-hawaii/' rel='bookmark' title='Geriatric Care Managers in Hawaii'>Geriatric Care Managers in Hawaii</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-idaho/' rel='bookmark' title='Geriatric Care Managers in Idaho'>Geriatric Care Managers in Idaho</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-maine/' rel='bookmark' title='Geriatric Care Managers in Maine'>Geriatric Care Managers in Maine</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-maryland/' rel='bookmark' title='Geriatric Care Managers in Maryland'>Geriatric Care Managers in Maryland</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-new-hampshire/' rel='bookmark' title='Geriatric Care Managers in New Hampshire'>Geriatric Care Managers in New Hampshire</a></li>
</ol>]]></description>
			<content:encoded><![CDATA[<p></p><p><img class="alignleft size-medium wp-image-7676" title="Two Reasons to Hire a Geriatric Care Manager Now" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2011/12/Two-Reasons-to-Hire-a-Geriatric-Care-Manager-223x300.jpg" alt="" width="223" height="300" /><span class="drop_cap">I</span> have the utmost respect for geriatric care managers, but I&#8217;m also a realist about the fact that <a title="What To Ask Before You Hire" href="http://www.geriatriccaremanagement.com/geriatric-care-managers/questions-to-ask-a-geriatric-care-manager/">not everyone can afford one</a>.</p>
<p>However, even when money is tight, there are a few instances in which the cost of a geriatric care manager is well worth it.</p>
<p>Below are the top two reasons to hire a geriatric care manager now:</p>
<p><strong>1) Your family is completely dysfunctional and <span id="more-7608"></span>all discussions end with no clear path forward. </strong> If you think you&#8217;re in this boat, you probably are.</p>
<p>Here&#8217;s what it looks like: You think your mom needs X, your brother thinks she needs Y, your sister is completely checked out of the picture, and your youngest brother thinks everything is fine. Oh, and mom has dementia so no longer has the capacity to make decisions for herself.</p>
<p>Hell might freeze over before everyone agrees on what should be done and the chances of you being able to bring everyone to consensus (sort of?) are slim. But a geriatric care manager? Well he/she can be the objective, professional, voice of reason.</p>
<p>Think your brothers might be more apt to consider the suggestions of a professional over your suggestions?  Even this only child knows the answer is a resounding YES! <img src='http://www.geriatriccaremanagement.com/wp-includes/images/smilies/icon_wink.gif' alt=';)' class='wp-smiley' /> </p>
<p><strong>2) Your concerns for mom/dad are growing and you find yourself wishing that someone could help you make sense of what you&#8217;re seeing.</strong></p>
<p>In other words, you&#8217;re overwhelmed by the complexity of the picture.  Mom isn&#8217;t showering anymore.  The doctor has started her on a depression medication that she&#8217;s refusing to take.  You can&#8217;t put your finger on when you first noticed a decline in her, but it&#8217;s clearly in full swing now and the avenues you&#8217;ve tried haven&#8217;t made anything better.</p>
<p>I&#8217;ve said this before and I&#8217;ll say it again:</p>
<p>One of the best ways to utilize the services of a geriatric care manager is to hire them for a consultation only&#8230;</p>
<p>They come in, they meet mom, they walk through the house, they hear the back story from you on what&#8217;s led up to your growing concerns, and they help you to understand what you&#8217;re looking at and what the next steps should be. If you find an experienced geriatric care manager, this is money well spent to help you get a handle on what&#8217;s going on.</p>
<p>So there you have it &#8211; two reasons to hire a geriatric care manager now.  If you hired a geriatric care manager to help you with mom or dad, what was it that finally made it happen?</p>
<p>Related posts:<ol>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers/' rel='bookmark' title='Geriatric Care Manager Directory'>Geriatric Care Manager Directory</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-manager-directory/' rel='bookmark' title='Join The Geriatric Care Manager Directory!'>Join The Geriatric Care Manager Directory!</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-hawaii/' rel='bookmark' title='Geriatric Care Managers in Hawaii'>Geriatric Care Managers in Hawaii</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-idaho/' rel='bookmark' title='Geriatric Care Managers in Idaho'>Geriatric Care Managers in Idaho</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-maine/' rel='bookmark' title='Geriatric Care Managers in Maine'>Geriatric Care Managers in Maine</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-maryland/' rel='bookmark' title='Geriatric Care Managers in Maryland'>Geriatric Care Managers in Maryland</a></li>
<li><a href='http://www.geriatriccaremanagement.com/geriatric-care-managers-in-new-hampshire/' rel='bookmark' title='Geriatric Care Managers in New Hampshire'>Geriatric Care Managers in New Hampshire</a></li>
</ol></p>]]></content:encoded>
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		<title>Three Things You Should Know About Sub-Acute Rehab (SAR)</title>
		<link>http://www.geriatriccaremanagement.com/2011/12/sub-acute-rehab/</link>
		<comments>http://www.geriatriccaremanagement.com/2011/12/sub-acute-rehab/#comments</comments>
		<pubDate>Mon, 05 Dec 2011 13:47:40 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Planning Care]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7604</guid>
		<description><![CDATA[Picture it: Your 89 year old father falls, breaks a hip and spends a week in the hospital. The discharge plan is not to home, but to Sub-Acute Rehab (SAR) &#8212; a fancy term for short-term, low-intensity rehabilitation that most often occurs inside of a nursing home. This is a scenario that plays out thousands [...]
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			<content:encoded><![CDATA[<p></p><p><img class="alignright size-medium wp-image-7658" title="&quot;I don't need any more rehab - WOOHOO!!!!&quot;" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2011/12/Sub-Acute-Rehab-300x294.jpg" alt="" width="300" height="294" /><span class="drop_cap">P</span>icture it: Your 89 year old father falls, <a title="15 Ways to Help a Parent Break a Hip" href="http://www.geriatriccaremanagement.com/2011/05/ways-to-break-a-hip/" target="_blank">breaks a hip</a> and spends a week in the hospital. The discharge plan is not to home, but to Sub-Acute Rehab (SAR) &#8212; a fancy term for short-term, low-intensity rehabilitation that most often occurs inside of a <a title="Five Reasons It’s Not Time For A Nursing Home" href="http://www.geriatriccaremanagement.com/2011/01/five-reasons-its-not-time-for-a-nursing-home/" target="_blank">nursing home</a>.</p>
<p>This is a scenario that plays out thousands of times every day across the country. If your aging parent is in this boat, below are three things you should know&#8230;<span id="more-7604"></span></p>
<p><strong>1) Sub-Acute Rehab is not the same as Acute Rehab &#8212; find out for sure which one is being recommended</strong> because there is a BIG difference&#8230;</p>
<ul>
<li>Acute Rehab is intense &#8212; 3-4 hours of rehabilitation per day</li>
<li>Sub-Acute Rehab is far less intense &#8212; approximately 30 minutes per day</li>
</ul>
<p>So who determines whether your aging parent is recommended for Sub-Acute Rehab vs. Acute Rehab?  Good question!</p>
<p>That would be the Physical Therapist (PT) in the hospital.</p>
<p>As discharge approaches, &#8220;PT&#8221; will visit your aging parent at bedside and attempt to get Mom/Dad out of bed with the goal of taking a stroll in the hallway.  Much of the decision is based upon how far (i.e. how many steps) your mom or dad can walk.  If it&#8217;s not many, Sub-Acute Rehab will likely be the recommendation.</p>
<p>(<em>Heads up though: if Mom/Dad can walk over 100 feet, he/she may not qualify for either.</em>)</p>
<p><strong>2) If your aging parent has Medicare and has been in the hospital for 3 or more days, there should be no out-of-pocket costs for a Sub-Acute Rehab stay</strong> BUT&#8230;</p>
<p>If you remember nothing else about Medicare, remember this: it only pays for <a title="Medicare vs. Medicaid – What’s the Difference &amp; Who Qualifies?" href="http://www.geriatriccaremanagement.com/2011/05/medicare-vs-medicaid-whats-the-difference-who-qualifies/" target="_blank">short-term services</a> (i.e. a few weeks to a month or two at most).  Here&#8217;s why that fact is REALLY IMPORTANT when we&#8217;re talking about Sub-Acute Rehab&#8230;</p>
<p>Imagine for a moment that it&#8217;s day 25 of your father&#8217;s stay in the Sub-Acute Rehab after breaking his hip. He isn&#8217;t much better. Let&#8217;s say, for argument&#8217;s sake, that he&#8217;s worse.  Being away from home depressed him. He didn&#8217;t like the food. He didn&#8217;t engage in the rehabilitation that was offered.  Instead, he stayed in bed and slept a lot.  After a few solid weeks of this, it&#8217;s now tough for him to get up at all.</p>
<p>And while Medicare was happy to foot the bill thus far, they will not continue to pay. So dad has come to a fork in the road. He can:</p>
<ul>
<li>Go home (but because of his physical state he&#8217;ll need more help than ever before to bathe and dress, etc.)</li>
</ul>
<p>or he can&#8230;</p>
<ul>
<li>Stay and transition into a long-term, nursing home bed.  (The cost of this could be as much as $14,000 per month. Unless Dad has Medicaid, it will be his responsibility to pay.)</li>
</ul>
<p>Think the prospects of an indefinite stay in the facility and the depletion of his savings are enough to depress Dad even more?  Yeah, I&#8217;ve seen that once or twice.</p>
<p>For those of you who are still with me, you&#8217;re probably wondering what the third thing to know about Sub-Acute Rehab could possibly be, so here it is:</p>
<p><strong>3) There is an alternative to Sub-Acute Rehab that&#8217;s not often talked about: <em>going home with home care</em>.</strong></p>
<p>That&#8217;s right, folks. Just as Medicare will pay for a brief stay in a Sub-Acute Rehab it will also often cover the cost of Physical Therapy at home. Typically this &#8220;home PT&#8221; occurs several times a week. And, it may also be possible to get Medicare to cover the cost of a home health aide to assist with <a title="ADLs: What Are They and Why Are They So Important?" href="http://www.geriatriccaremanagement.com/adls/" target="_blank">activities of daily living</a> during the same service window.</p>
<p>Of course there could be reasons why Sub-Acute Rehab may make the most sense for your aging parent.  Maybe he/she has medical needs that complicate the picture so that a discharge to home &#8211; even with home care &#8211; really would be unsafe.</p>
<p>But do I think you should ask the Physical Therapist and/or the medical team to explain why home PT isn&#8217;t best?</p>
<p>You bet I do.</p>
<p>&nbsp;</p>
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		<title>This Is Me, Giving Thanks</title>
		<link>http://www.geriatriccaremanagement.com/2011/11/this-is-me-giving-thanks/</link>
		<comments>http://www.geriatriccaremanagement.com/2011/11/this-is-me-giving-thanks/#comments</comments>
		<pubDate>Wed, 23 Nov 2011 15:21:50 +0000</pubDate>
		<dc:creator>Maria</dc:creator>
				<category><![CDATA[Miscellaneous]]></category>

		<guid isPermaLink="false">http://www.geriatriccaremanagement.com/?p=7574</guid>
		<description><![CDATA[Creating this website was as big a goal as I&#8217;d ever set.  It seemed difficult and improbable.  I wasn&#8217;t sure where to begin or how I&#8217;d find my way. I didn&#8217;t want to pay someone to show me. During this time I e-mailed other bloggers a lot.  Most responded with encouragement, but two in particular [...]
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			<content:encoded><![CDATA[<p></p><p><img class="size-medium wp-image-7581 alignright" title="Happy Thanksgiving!" src="http://www.geriatriccaremanagement.com/wp-content/uploads/2011/11/Thank-you-300x262.jpg" alt="" width="300" height="262" /><span class="drop_cap">C</span>reating this website was as big a goal as I&#8217;d ever set.  It seemed difficult and improbable.  I wasn&#8217;t sure where to begin or how I&#8217;d find my way. I didn&#8217;t want to pay someone to show me.</p>
<p>During this time I e-mailed other bloggers a lot.  Most responded with encouragement, but two in particular offered words of advice that stirred me up inside.  I quickly printed their e-mails and taped them to the wall above my desk for inspiration.</p>
<p><strong></strong>Elise Bauer of <strong><a href="http://www.simplyrecipes.com">Simple Recipes</a></strong> was first. I&#8217;d found her website through an article that appeared in Redbook about <a href="http://www.redbookmag.com/health-wellness/advice/inspiring-women-bloggers" target="_blank">inspiring female bloggers</a>.  Not only are Elise&#8217;s recipes delicious and her photography stunning, but it turns out she&#8217;s also a really nice human being.  Her advice was straightforward and simple.</p>
<blockquote><p><em><span style="color: #000000;">Buy an Apple computer.  Acknowledge that the learning curve will be steep and you&#8217;ll have to work hard at this before you begin to see results. And, go for it because your goal is within reach.</span></em></p></blockquote>
<p>That last part really grabbed me because she didn&#8217;t have to say it.  But she did&#8230;<span id="more-7574"></span></p>
<p><strong></strong> Tim Carter of <strong><a href="http://www.askthebuilder.com">AsktheBuilder.com</a> </strong>responded within hours of Elise Bauer. I&#8217;d found Tim through a Wall Street Journal article that profiled people who were making more than a million dollars a year through their websites.  He&#8217;d built his site from scratch and it gave me hope that I could do the same. In a weak moment I asked the builder what to do with the doubt I was feeling with this project. He responded by issuing me a challenge.</p>
<blockquote><p><em><span style="color: #000000;">&#8220;How badly do you want this? If you want it badly enough you will not let anything stop you. Only people with diligence, discipline and determination make it. Are you one of those?&#8221;</span></em></p></blockquote>
<p>Strong words from a stranger that gave me the final kick in the tail that I needed.  I launched the site a few months later having taught myself how to build it.</p>
<p>Along the way, there have been many other people whose support and encouragement have been invaluable.  My husband, of course. My mother.  Several friends and extended family members&#8230;</p>
<p>But these days I&#8217;m happy to report that it&#8217;s also the readers &#8212; everyday folks who stumble upon this site and take a moment to leave a comment after a post or reply to an e-mail to say thanks for <a href="http://www.geriatriccaremanagement.com/ask-maria" target="_blank">a response I&#8217;ve provided</a> to one of their questions.</p>
<p>Here&#8217;s some of the comments that have inspired me most:</p>
<blockquote><p><em><span style="color: #000000;">&#8220;Maria, thank you for answering me so quickly.  Your advice was spot-on and I will relay it to my brother and sister-in-law&#8230;&#8221;</span></em></p>
<p><em><span style="color: #000000;">&#8220;Your post really nailed-it.&#8221;</span></em></p>
<p><em><span style="color: #000000;">&#8220;I&#8217;m so glad I found this site!&#8221;</span></em></p></blockquote>
<p>And the absolute best is when caregivers pitch in to help one another in the comments.</p>
<p>A reader named Anne writes:</p>
<blockquote><p><em><span style="color: #000000;">&#8220;I got my mother a shower chair with a transfer bench recently. She won’t use it because she can’t figure out how to get the shower curtain around the chair so the water doesn’t get all over the bathroom floor. Ideas?&#8221;</span></em></p></blockquote>
<p>Another reader uses the comment section to help&#8230;</p>
<blockquote><p><em><span style="color: #000000;">&#8220;This is for Anne in regards to the shower curtain issue: Just cut 2 slits in the shower curtain, one on each side of the bench seat that extends outside the tub. Then just slide that “middle” piece of the shower curtain down into the bench seat crack, which allows the whole shower curtain to remain inside the tub. It takes a little practice because some of the bench seat cracks are wider on some shower transfer chairs than others, but it does the trick just perfect. Hope this helps.&#8221;</span></em></p></blockquote>
<p>All of this &#8212; the words that inspired me to get going and the ones that keep me going &#8212; helps to convince me that I&#8217;m on the right path.  I take them as small signs of a community that is just beginning to grow. One that I intend to nourish with everything I&#8217;ve got.</p>
<p>So HAPPY THANKSGIVING to everyone who&#8217;s reading this. I hope this website helps you to manage whatever caregiving challenge you may be facing and that you&#8217;ll come back again.</p>
<h2>Maria</h2>
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